Data acquisition quality and data fusion for personal portable wireless vital signs scanner

ABSTRACT

In one embodiment of the invention, an interactive vital signs scanning method is disclosed including concurrently scanning for a plurality of vital signs with a portable vital signs scanner; detecting movement of the portable vital signs scanner during the scanning for the plurality of vital signs; and determining a measure of quality of the scanning for the plurality of vital signs with the portable vital signs scanner. In another embodiment, a method of improving the quality of vital signs data is disclosed including concurrently sensing data from a plurality of vital signs sensors over a period of time with a portable vital signs scanner; determining a plurality of vital sign values for a respective plurality of vital signs in response to the sensed data from the plurality of vital signs sensors over the period of time; and fusing at least two vital sign values of the plurality of vital sign values for the respective plurality of vital signs.

CROSS REFERENCE TO RELATED APPLICATIONS

This non-provisional patent application claims priority to U.S.provisional patent application No. 61/875,681; entitled SYSTEMS,METHODS, AND APPARATUS FOR PERSONAL PORTABLE WIRELESS VITAL SIGNSSCANNER filed by inventors Wenyi Zhao et al., on Sep. 9, 2013; and U.S.provisional patent application No. 61/924,230; entitled DATA ACQUISITIONQUALITY AND DATA FUSION FOR PERSONAL PORTABLE WIRELESS VITAL SIGNSSCANNER filed by inventors Wenyi Zhao et al., on Jan. 6, 2014; both ofwhich are incorporated herein by reference.

FIELD OF THE INVENTION

This invention generally relates to vital signs scanning with a portabledevice having multiple integrated vital sign sensors.

BACKGROUND OF THE INVENTION

Healthcare is a key element of any modern society. Over the years, ithas brought people the benefit of the latest technological breakthroughsthat are safeguarded by well-established regulatory process. Thepractice of medical practitioners has also evolved into highlyspecialized fields and subfields. One of the most important aspects ofmedicine is preventive care. A significant portion of healthcare costscould be reduced if ailments are diagnosed early. Yet many of the toolsto diagnose early symptoms are unavailable to the average consumer.

Vital signs of one's body, such as temperature for example, form thebase map of ones health. Fluctuations in our vital signs may bepredictive of undiagnosed ailments. It's important to have easy accessto their vital signs as frequently as needed. Yet the average consumerhas no easy method of obtaining many of their vital signs withoutvisiting a hospital or clinic. One of the easiest-to-measure vital signsis body temperature. Consumers are able to measure body temperature athome with an inexpensive home thermometer. However the average consumerstill does not have easy access to devices for measuring the otherimportant vital signs of ones body, such as blood oxygenation or bloodpressure for example. The technology is available to measure theimportant vital signs, but typically limited to clinics and hospitals.

Consumers do not have a way to measure all of their important vitalsigns at home. Consumers cannot visit their physician five or more timesa day to constantly monitor their vital signs. This has put the averageconsumer with a medical condition into a difficult situation, where theydo not know what to do with their condition when they need vital signsinformation while at home or traveling. The few options the averageconsumer has with an unknown medical condition include staying calm anddoing nothing, calling their primary care providers (PCP) to get anappointment, or visiting an emergency room (ER) and waiting for hours.

Even if the consumer opted to do one of the latter options, the PCP orER may not be able to provide personalized advice without knowing thespecifics about their patients. The physician may have some idea aboutone's health condition based on an annual exam but the data may beoutdated and useless with a current medical condition.

As a result, the average consumer may not receive the best medical caredue to the lack of information. And together, with PCPs, we also manageto add more cost to the healthcare system that is already very expensiveas people live longer.

The problem, simply put, is that consumer access to basic health care israther limited. It is desirable to improve the quality and access tobasic health care for average consumers.

SUMMARY OF THE INVENTION

The embodiments of the invention are best summarized by the claimsbelow. Insofar as a summary is required, one embodiment of the inventioncan be described as a portable vital signs scanner with an interactiveuser interface to improve scan data quality.

This summary is provided to efficiently present the general concept ofone or more embodiments of the invention and should not be interpretedas limiting the scope of the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features, aspects, and advantages of the presentdisclosure will now be described with reference to the drawings ofembodiments, which embodiments are intended to illustrate and not tolimit the disclosure, as are described in varying degrees of detailbelow.

FIG. 1A is a diagram illustrating an exemplary vital signs scanningsystem with the scanner held at the forehead/temple.

FIG. 1B is a perspective view of a user squeezing the exemplary vitalsigns scanner.

FIG. 1C is a diagram illustrating a portable wireless multifunctionaldevice with a scan screen of a vital signs scanning user interface.

FIG. 1D is another diagram illustrating an exemplary vital signsscanning system with the scanner held at a chest position.

FIGS. 1E-1F are diagrams illustrating how microphones of the exemplaryvital signs scanner can capture body sounds, such as from a user's heartor lung.

FIG. 1G is another diagram illustrating an exemplary vital signsscanning system with the scanner held in fingers of each hand.

FIG. 2A illustrates an exemplary portable wireless multifunction deviceto execute the vital signs scanning application.

FIG. 2B illustrates a schematic representation of the components of theportable wireless multifunctional device.

FIG. 3A is an exemplary health status window displayed on the portablewireless multifunctional device by the vital signs scanning userinterface (VSUI).

FIG. 3B is an exemplary scan results window displayed on the portablewireless multifunctional device by the vital signs scanning userinterface.

FIG. 3C illustrates exemplary slide windows generated on the portablewireless multifunctional device by the vital signs scanning userinterface.

FIG. 3D illustrates an exemplary second scan selection window of thevital signs scanning application on the portable wireless device.

FIGS. 4A-4B illustrate a temperature averaging window generated in atouch screen of the portable wireless multifunction device by the vitalsigns scanning software application.

FIGS. 5A-5E illustrate prognosis windows for vital signs in a touchscreen of the portable wireless multifunction device.

FIGS. 6A-6B are perspective views of an embodiment of the invention.

FIGS. 6C-6D are perspective views of another embodiment of theinvention.

FIG. 7A is an exploded view of the exemplary portable wireless vitalsigns scanner.

FIG. 7B illustrates a partially assembled exemplary portable wirelessvital signs scanner.

FIG. 8A illustrates a functional block diagram of electronic circuitrywithin the exemplary portable wireless vital signs scanner.

FIG. 8B illustrates a main printed circuit board coupled to a daughterprinted circuit board with various electronic circuitry within theexemplary portable wireless vital signs scanner mounted to each.

FIG. 9 illustrates an exemplary hierarchy of the vita signs graphicaluser interface provided by the vital signs scanning software applicationexecuted by the personal wireless multifunction device.

FIGS. 10A-10B illustrate diagrams of sources of movement of the vitalsigns scanner that can degrade data capture.

FIGS. 11A-11C illustrate diagrams of sources of various degraded qualityin the capture of vital signs data by the vital signs scanner.

FIG. 12 illustrates a functional block diagram of the interactivescanning system.

FIGS. 13A-13B illustrates exemplary graphs of determining quality ofvital signs data within an expected range.

FIG. 14A illustrates exemplary graphs of forming an envelope curve ofvital signs data.

FIG. 14B illustrates an exemplary graph of determining quality of vitalsigns data with a pair of threshold levels.

FIG. 15A illustrates a functional block diagram of the interactivescanning process and user feedback (feedback to the user from thescanner and/or portable wireless device) when remaining in the same scanstate.

FIG. 15B illustrates a functional block diagram of the interactivescanning process and user feedback (feedback to the user from thescanner and/or portable wireless device) when transitioning to adifferent scan state.

FIG. 16 illustrates a functional block diagram of the methods of datafusion for improving vital sign measurement quality.

FIGS. 17A-17C illustrates exemplary graphs to confirm the quality ofvital signs data with an expected curve.

DETAILED DESCRIPTION

Many alternative embodiments of the present aspects may be appropriateand are contemplated, including as described in these detailedembodiments, though also including alternatives that may not beexpressly shown or described herein but as obvious variants or obviouslycontemplated according to one of ordinary skill based on reviewing thetotality of this disclosure in combination with other availableinformation. For example, it is contemplated that features shown anddescribed with respect to one or more particular embodiments may also beincluded in combination with another embodiment even though notexpressly shown and described in that specific combination.

For purpose of efficiency, reference numbers may be repeated between thefigures where they are intended to represent similar features betweenotherwise varied embodiments, though those features may also incorporatecertain differences between embodiments if and to the extent specifiedas such or otherwise apparent to one of ordinary skill (such asdifferences clearly shown between them in the respective figures).

It is desirable for consumers to take greater control of their own basichealth and work with their primary care providers (PCPs) to providepersonalized healthcare. Some embodiments of the invention provide aconsumer device that is small enough to be carried in a pocket or pursewith which effortless vital signs scans can be performed, anytime,anywhere. The consumer device, referred to as a vital signs scanner, cantransfer the vital signs results to a portable wireless multifunctiondevice, such as a smartphone, for storage and display to a user overtime to illustrate health trends. The vital signs scanner allowsconsumers to take greater control of their own basic health and workwith PCPs to provide personalized healthcare.

The vital signs scanner allows users to efficiently measure multiplevital signs simultaneously. Vital signs scanning with the vital signsscanner is quick and easy and very convenient in that it cansimultaneously capture a plurality of vita signs data with one scanningsession (one or two vital signs scans) at a given time and date. Thevital signs data is transferred to a user's own portable multifunctiontouch screen device, e.g. a smart phone. The portable multifunctiondevice, with the assistance of vital signs scanning software, displaysthe scanning results in an intuitive user interface that is simple tounderstand.

The vital signs scanning device provides a method of vital signsscanning to help solve the missing information link so a user can takecontrol of managing his/her own health. In addition to providing vitalsigns scanning, the vital signs scanner and system also stores the usersvital signs measurements and trends over time of a day and date. Thevital signs scanner and system provides easy access (almost anywhere atanytime) to important vital signs measurements such as bloodoxygenation, blood pressure, heart rate, etc. The vital signs scannerand system can help share up-to-date vital signs data with a user's PCPfor better diagnosis of medical conditions. Perhaps even moreimportantly, sharing of history and trends of vital signs data beforeand after an ailment with the user's PCP can provide clues to its causeand not just indicate the symptoms.

The personal wireless vital signs scanner combines aesthetic design withfunctionality. The personal wireless vital signs scanner is light weightand easily fits into one hand. The personal wireless vital signs scannercan be held and operated with just two fingers of one hand. The user'sother hand is free to hold a smartphone with a vital signs scanningapplication running to control the vital signs scanning process and viewthe scanning results. Vital signs data of a users body can change atdifferent times of each day. The personal wireless vital signs scanneris so small, light, and esthetically pleasing that a user may desire totake it with them to perform a plurality of vital signs scans atdifferent times throughout his/her day over a plurality of days.

The vital signs scanner may fuse data together from various datasources, referred to as a fusion process, in different ways in order toincrease measurement accuracy, increase quality control of dataacquisition, and/or provide additional information to a user. The datathat may be fused together includes concurrent information or datastreams originating from different sensors in the vital signs scanner;different information in a data stream originating from the same sensor;information in an internal data stream from a sensor in the vital signsscanner and external generated data, such as data originating from auser's input, biometrics or one or more databases; or any combinationthereof. To facilitate the fusion process, the data streams may besplit, independently processed in parallel, and recombined or comparedagainst each other depending on the needs for the information. Forexample, a fusion process may involve comparing scan data in independentdata streams from a plurality of sensors to cross-validate the qualityof their scan data.

A portable vital signs scanner and system may prove to be useful forhealthcare professionals as well. For example, patients could scan fortheir own vital signs themselves in a busy hospital, clinic or doctorsoffice, rather than wait in long lines just to get a simple checkupbefore seeing the doctor. The patients scans are then uploaded to aserver at the hospital, clinic, or office. With these self-obtainedvital signs scans of patients being uploaded to a server, medicalassistants and nurses, ordinarily checking for vital signs, can betterspend their time curing the ailments of the patients.

The self-obtained vital signs scans of patients may also serve to triagethe patients that are waiting for medical care. For example, aself-obtained vital signs scan of a patient indicating an elevated orirregular heart rate may signal hospital staff to attend to this patientimmediately or at least a higher priority in a queue of patients. Inthis manner, the self-obtained vital signs scans of patients provide aclinic staff with a sense of the severity of the condition of patientswaiting and can make appropriate schedule priority adjustments, ifneeded.

Referring now to FIG. 1A, a diagram illustrating a vital signs scanningsystem 100 is shown. The scanning system 100 includes a portablewireless vital signs scanner 102 and a portable wireless multifunctiondevice 104 in wireless communication with each other over a wirelesscommunication channel 103A. The vital signs scanner 102 includes aplurality of sensors designed to read vital signs from a user's body101. An instance or snap shot of vital signs, such as temperature, heartrate, blood oxygenation (SpO2), electrocardiogram (ECG), and possiblystress levels, all synchronously measured, can be reported to the device104 by the scanner 102 in less than a minute. Exemplary methods andalgorithms for determining one or more of these vital signs from thesensor data are described in International Application No.PCT/US2013/061046, filed by Scanadu Corporation on 19 Oct. 2012, havinginternational publication no. WO 2013/066642, entitled AUTOMATEDPERSONAL MEDICAL DIAGNOSTIC SYSTEM, METHOD, AND ARRANGEMENT, claimingpriority to U.S. Patent No. 61/549,134 filed on 19 Oct. 2011, and ishereby incorporated by reference.

The algorithms and processes disclosed in International Application No.PCT/US2013/061046 are based upon one or more of the following references(all of which are incorporated herein in their entirety): Pulse transittime: an appraisal of potential clinical applications, Thorax 1999;54:452-457 [doi:10.1136/thx.54.5.452][http://thorax.bmj,com/content154/5/452.full]; U.S. Pat. No. 6,723,054;U.S. Pat. No. 6,527,728; U.S. Publication No. 2007/0276632; and U.S.Publication No. 2003/0199771; Severinghaus, John W., Honda Yoshiyuki(April 1987), “History of Blood Gas Analysis. VII. Pulse Oximetry”,Journal of Clinical Monitoring # (2): 135-138; Millikan G. A. (1942).“The oximeter: an instrument for measuring continuouslyoxygen-saturation of arterial blood in man”, Rev. Sci.Instrum 13 (10):434-44 [doi:10.1063/1.1769941]; U.S. Pat. No. 6,385,471; U.S. Pat. No.5,934,277; U.S. Pat. No. 5,503,148; U.S. Pat. No. 5,351,685; U.S. Pat.No. 5,259,381; U.S. Pat. No. 4,883,353; U.S. Pat. No. 4,824,242; U.S.Pat. No. 4,807,631; U.S. Pat. No. 4,796,636; U.S. Pat. No. 4,714,080;U.S. Pat. No. 4,623,248; and U.S. Pat. No. 4,266,554.

Integration of multiple sensors and scan quality algorithms make itpossible to monitor the quality of the scanning process and then providefeedback to the user to control the interactive scanning process andprovide a good user experience in the vital signs scanning process. Asused herein, user feedback means feedback provided by the scanner and/orportable wireless device through the user interface or otherwise to theuser, including any scan quality feedback that is provided to the user.User input means any input that a user provides to the scanner and/orportable wireless device.

The wireless vital signs scanner 102 may perform vital signs scans anddisplay the results in under a minute. Generally scans may be completedin approximately ten seconds. The length of a scanning session maydepend on the user's ability to correctly utilize the scanner 102. Forexample, if the user moves too much during the scanning session, thesession will last longer as the device 104 prompts the user to remainstill.

Different types of scans may also take different lengths of time. Forexample, in a standard ten second head scan where the scanner is heldagainst a user's forehead or temple (forehead/temple), temperature,SpO2, ECG, heart rate, and blood pressure may be measured. For a thirty(30) second extended head scan, vital signs such as blood pressure andheart rate variability (related to emotional stress) may be captured.For a thirty second chest scan from a user's chest, respiration rate andbody sounds may be measured or collected. In any case, the scanningsessions are still short and convenient.

Short scanning sessions have several advantages. A short scanningsession allows a user to take a quick break from their daily activitiesto perform a scan anywhere and at any time. The ease and rapidness ofperforming a vital signs scan will encourage users to perform the scanmultiple times a day, providing more complete and accurate trendingdata. The invention provides a consumer oriented scanner that a user canuse anytime anywhere to obtain multiple vital sign measurements inseconds.

Short scanning sessions also conserve power. With ten second scans, thescanner may last approximately one week under normal usage with one fullbattery charge. If the power is on for a total of about 30 seconds foreach scan, then total power-on time for each day is less than one hourwith 100 scans per day. In this case, the scanner 102 may operate for aweek at a time between battery recharging sessions.

Scanner 102 is an elegant consumer device that is portable. Unlike othervital sign monitors, scanner 102 does not need to be worn. Scanner 102is perhaps the smallest consumer device that can measure multiple vitalsigns simultaneously. Measuring approximately 60 mm in diameter and 18mm high, the scanner 102 can be easily places in a pocket or purse foruse at any time convenient to the user. At any time the user has amoment to spare, the scanner 102 may be used to obtain multiple vitalsign measurements by simply finger-holding it against the user'sforehead/temple, and/or chest.

Using a multifunction device 104 to display the vital signs scanningresults allows the scanner 102 to maintain a compact size and minimalistform. Multifunction device 104 may be any portable wirelessmultifunction device such as a smartphone, tablet PC, or the so calledsmart watches. Generally these devices are pre-owned and alreadyavailable to the average consumer, so utilizing the display capabilitiesof multifunction device 104 does not detract from the portability of theinvention. The ubiquity of smartphones also means that the averageconsumer does not need to pay more for a dedicated display device.Combining the vital signs scanner 102 with, a smartphone that a useralready has, allows one to take control and greater responsibility forhis/her health without sacrificing valuable time and money.

To display the vital signs scanning results, the portable wirelessdigital device 104 executes a vital signs scanning software application140. The instructions of the vital signs scanning software application140 are executable with the operating system, (e.g., Android and iOS),of the multifunction device 104. Once the software application isactive, the user may power up the vital signs scanner 102. Upon powerup, the vital signs scanner 102 is paired with the portable wirelessdigital device 104 to form the communication channel 103A between them.Accordingly, each of the scanner 102 and multifunction device 104 has acompatible wireless radio to form a compatible wireless communicationchannel. In one embodiment, the communication channel 103A is aBluetooth version 4, a smart low energy (LE) supported channel that eachwireless radio supports. The vital signs scanner 102 sends the vitalsign information wirelessly to the portable wireless multifunctionscanner 102 over the wireless communication channel 103A for storage andfurther analysis.

With the communication channel 103A available, the vital signs scanner102 is pressed against a user's forehead/temple. The forehead/temple isidentified as the single place with enough blood vessels and thin skinso that temperature, pulse oximetry and ECG can be obtained in sync andtime-stamped. A scanning button is pressed on the user interface of theapplication 140 of the portable wireless multifunction device 104 tostart the scanner 102 scanning for vital signs information of the user.After scanning for approximately 10 seconds or less, the vital signsscanner 102 sends the vital sign information wirelessly to the portablewireless multifunction device 102. The multifunction device 104 maydisplay the results of the scan on a touchscreen display.

The vital signs scanner 102 is used periodically to scan for vital signseach day. Statistical information regarding a plurality of scans eachday over a plurality of days can be generated and displayed on thetouchscreen display device of the device 140. The vital signs scanningsoftware application 140 informs a user of how those vital signmeasurements may change during times of a day and over a plurality ofdays.

An important aspect of the invention is the quality of the scanningresults. To optimize the scanning session results, the scanner 102 isdesigned to be easy to use to minimize user error. Similarly, thescanning software application is intuitive and easy to use. With minimalinstruction, an average user can generate medical grade vital signsscans within minutes of using the invention for the first time.

To further optimize scanning results, scan quality algorithm monitor thevita signs scanning process and provides feedback (visual and/oraudible) to the user through the multifunction device 104, and/oralternatively an optional sound generator (see audible sound generator847 in FIGS. 8A-8B) in the scanner 102. The user feedback may help theuser to perform a better vital signs scan with the wireless vital signsscanner and acquire good quality vital signs measurements.

Integration of multiple sensors allows for synergistic accuracy of vitalsigns scans. For example, integration of an accelerometer enables motiondetection that is often associated with poor signals of pulse oximetryand ECG. In another example, abnormal signals of both pulse oximetry andECG suggest the device is not held against the body properly. This canbe further confirmed by comparing the surface temperature and ambienttemperature of the sensor when not in touch with the user.

Quality checking of individual vital sign measurements is based onfusion of data from multiple differing sensors, including a motionsensor, such as an accelerometer. Signal quality may be checked based ondynamic range detection and thresholding, for example. To make theprocess more robust, known signal processing techniques, such asenvelope detection, can be applied to the raw signals from the sensorsas a preprocessing or screening step. Quality checking of raw sensorsignals from the sensors makes sensor data fusion more robust byrejecting bad signals. Thus, fusing results of multiple sensors canprovide better individual measurements of each vital sign.

The intuitive scanning user interface (UI) is designed, in combinationwith scan quality algorithms and the device's self-diagnosticcapability, to help users to finish a vital signs scan successfully.There is the quality indicator from the quality algorithm, the progressbar, and texts that provides feedback to the user to ensure a successfulscanning session. For example, suggestions to “hold still” or “holddevice to your forehead/temple” may prompt the user to correct his/herpoor scanning behavior.

The scanning system 100 is user friendly so that it can be used multipletimes during the day to obtain data about a user's body 101. One personor one family can exclusively use the scanning system 100 and scanner102 at home as a personal vital signs scanner. In this manner, a measureof one's personal health and medical data can be obtained right at homewith the scanning system 100 without seeing a doctor or being admittedto a hospital. Each scan only lasts approximately ten to thirty secondsand obtains multiple vital sings measurements so users can take the scanrepeatedly throughout the day without being inconvenienced.

The scanning system 100 can be used to personally analyze and trackone's own vital signs to see various trends over time. Accordingly, thevital signs data can be accumulated over a plurality of days and aplurality of scans at various times each day, then stored innon-volatile manner with the device 104 so the data does not get lost.The vital signs data can also be backed up to a computer, a storagedevice, or storage server so it is not lost if the device 104 is lost orstolen. The storage server having greater storage may also be used toaccumulate ones user data over a plurality of years when the device 104is limited by its built-in storage capacity.

In operation, the vital signs scanning system 100 forms an electricalcircuit 150 with the user's body 101. The circuit 150 is formed betweenfirst and second electrodes of the portable wireless vital signs scanner102. From a first electrode of the scanner 102, the circuit 150 is madewith the fingers 111, the hand 112, the arm 113, the chest 114, the neck115, and the head 116 of the user's body 101 to a front electrode.Preferably, the portable wireless vital signs scanner 102 forms anelectrical connection to the forehead/temple portion of the head 116 ofa user's body 101. Fingers 111 not only serve to hold the scanner 102,but also as one contact point for one-lead ECG (the other one-lead ECGcontact point is forehead/temple). Preferably the thumb finger 111 inone embodiment and the index finger in another embodiment forms anelectrical connection with the portable wireless vital signs scanner102.

The vital signs scanning system 100 may optionally include a personalcomputer 150 in wireless communication with the portable wireless vitalsigns scanner 102 over an alternate or additional wireless communicationchannel 103B.

Referring now to FIG. 1B, a perspective view of a user's fingers111A-111B squeezing the vital signs scanner 102 is shown. The vitalsigns scanner 102 is squeezed between the user's fingers to form atleast one electrical connection. The front side sensors and a frontelectrode in the vital signs scanner 102 are then pressed against theuser's forehead/temple to form an addition electrical connection. Thesmall size 60 mm×60 mm×18 mm allows the scanner 102 to be held by justtwo fingers of one hand. At a weight of approximately 60 g, the scanner102 may be used by just about any person, from a child to the veryelderly. Finger-held form-factor, ten to thirty seconds per scan, scanquality algorithm with feedback and an intuitive scanning user interfaceon a personal portable multifunction device, all help make vital signsscanning fast and easy while producing quality results.

Preferably, the scanner 102 is held between the thumb 111B andforefinger 111A of the user's left hand. The forefinger 111A may alsorest over a sensor 121 and forms an electrical connection to anelectrode around the sensor in one embodiment. In another embodiment,the thumb finger 111B makes contact with a bottom electrode 122B. Thethumb of the left hand couples to the bottom electrical contact(electrode) on the bottom-housing portion of the scanner.

The forefinger makes contact with a rectangular glass plate over anoximeter sensor 121 in one embodiment. In another embodiment, theoximeter sensor 121 is moved to the front side of the vital signsscanner 102 so that extraneous light is less likely to interfere withthe its readings.

A front side electrode 122F makes contact with the user's forehead ortemple (forehead/temple), when it is pressed up against his/her head. Aninfrared (IR) thermometer sensor is combined with the front sideelectrode 122F. The IR thermometer sensor makes temperature readings atthe user's forehead/temple. An oximeter sensor may also be located nearthe front side electrode 122F.

With the thumb finger 111B in contact with the bottom electrode 122B, acircuit may be formed through the finger and the hand of the user and aportion of his body back to the front side electrode 122F in the vitalsigns scanner 102. Once proper placement of scanner 102 is made, a scanbutton is selected in the software application 140 of the device 104 tocommand the scanner to scan the vital signs from the user's body andforward them to multifunction device 104.

Referring now to FIG. 1C, an exemplary initial scan screen window 140Aof the vital signs scanning application 140 is illustrated. The initialwindow 140A includes an instruction scan messaging 147 with instructionscan message text and optionally an instruction figure to show the userhow the vital signs scanner 102 is utilized. As indicated by theinstruction scan message, the user is to keep holding the scanner to theuser's left temple for the best scan.

The initial window 140A further includes a menu button 161, a backbutton 162, an edit button 163D, a tag information button 164, a healthstatus button 180, and a done button 190. The tag information button 164is used to add user information as well as tag scans with thecircumstances under which a scan was undertaken, such as after eating orafter exercise. The initial window 140A includes a user information bar163 including information regarding a user's height, user's name 163B,user's weight 163C, and a user's profile picture 163E. In this manner,the user is clear as to whom is logged into the vital signs scanner userinterface and for who's body is to be canned. The initial window 140Afurther includes a scan type indicator 173, indicating a head scan typeduring a first scanning or a chest scan type during a second scanningperiod. The initial window 140A further includes a scan qualityindicator 175, a scan progress bar 146, and a scan progress percentageindicator 146. The scan quality indicator is one form of qualityfeedback that may be employed by the scanning system to inform and trainthe user to acquire better scan data. The initial window 140A furtherincludes a scan type slider 171 to select the type of scan that is to beperformed. The menu button 161 can take the user to the next screen or adifferent screen within the vital signs scanning user interface. Theedit button 163D can edit information and select options that areavailable in the vital signs scanning application 140.

The vital signs scanning application 140 may include an option to enterthe user's symptoms by selecting the health status button 180. A photomay also be taken of the medical condition of a user by use of a camerain the device 104 and a photo button. Additionally, a user may add anote to his health status using the device 104 and an add note button.

The status of the scanner 102, such as powered on/off, Bluetoothconnection, battery charge status, and/or ready to scan, may also bedisplayed in one or more of the user interface windows of the vitalsigns scanning application 140.

The scanner 102 can collect a diverse set of physiological information(e.g., vital signs) during one or two acquisition periods totalingapproximately sixty seconds (head scan, extended head scan, and/or chestscan).

Referring now to FIG. 1D, a diagram of an exemplary vital signs scanningsystem with the scanner held at the chest position is illustrated. Inthis embodiment, vital signs are first acquired from a first scanningperiod (e.g., approximately 10-second scan) at the forehead/temple asshown in FIG. 1A. Vital signs may further be acquired by secondaryscans. A longer or extended scan at the forehead/temple with the scanner102 may be used to capture sensor data as shown in FIG. 1A during asecond scanning period. Alternatively or additionally, a subsequent scanconducted near the chest of the user may be performed during anotherscanning period, such as shown in FIG. 1D.

A secondary extended scan at the forehead/temple may be over a range oftime from about thirty seconds up to a minute so that measures of heartrate variability and respiration rate may be obtained. The secondaryextended scan at the forehead/temple can also provide for a more robustand accurate measurement of blood pressure. In terms of using thescanner, the primary and secondary scans at the forehead/temple mayoccur in one single scan (e.g., 10-second or 30-second) or two separatescans (e.g., a first at 10 seconds and then a second at 30 seconds).

The secondary extended scan near the chest, a chest scan, is mainly tocapture vital signs of respiration rate and additional physiologicalinformation from the captured body sounds. The vital signs scanned atthe chest area may also include heart rate variability. Noise may alsobe captured in the signals captured by the sensors of the scanner thatcan be used to better extract the desired signal data. The secondaryextended scan near the chest may last for a period from thirty secondsto a minute. The vital signs scanning application executed on themultifunction device 104 may prompt the user for one or both scanlocations.

The secondary chest scan can be selected by the scan type slider 171shown in FIG. 1C. A second or third scan may be selected with a fingerswipe to perform the second scan or the third scan at the chest of theuser. If only the first head scan was desired, a done button 190 may beselected to avoid the secondary scans. This may be because itsinconvenient due to timing or to perform against ones chest with thevital signs scanner, such as when it is inconvenient to do so in public.

As mentioned herein, a chest scan may be performed with the scanner 102as shown by FIGS. 1D, 1E, and 1F, for example. In FIG. 1D, a secondcircuit 150′ may be formed with the users body 101 between theelectrodes of the scanner 102. The second circuit 150′ in this caseincludes the chest 114, the arm 113, the hand 112, and the finger 111 ofthe user.

In an alternate embodiment, another circuit 150″ may be formed with theusers body between the electrodes of the scanner 102 while the device104 is nearby. This alternate circuit 150″ is formed by fingers ondifferent hands coupling to the electrodes of the scanner 102. A leftfinger 111L may couple to a bottom or top electrode in the scanner 102.A right finger 111R may be coupled to the front electrode of the scanner102. From a left finger 111L in a left hand 112L of the user, thecircuit in the body includes, the left finger 111L, the left hand 112L,the left arm 113L, the chest 114, the right arm 113R, the right hand112R, and a right finger 111R, such as shown in FIG. 1G, to complete acircuit with the scanner 102.

In either case, the ECG circuitry in the scanner 102 may then obtainfurther data regarding heart activity of the user that can becombined/fused with the heart activity data of a first scan, to improvethe measure of vital signs of heart activity. The vital sign measures ofheart activity may then be sent to the device 104 for display to theuser on its built-in touchscreen display.

Temperature of the body adjacent the user's chest 114, if reliable, mayalso be used by the scanner to improve scanning results of temperature.Temperature at the user's finger 111R, if reliable, may also be used bythe scanner to improve scanning results of temperature.

With the scanner adjacent the users chest, near or over the heart duringthe chest scan, clothed or unclothed, an accelerometer (seeaccelerometer 885 in FIGS. 8A-8B) in the scanner 102 may be used tocapture movement of the chest as a measure of respiration rate. Thevital signs data from these measures are computed by the processor 840and then sent to the device 140. With the accelerometer within thescanner 102, data for measuring heartbeat and respiration rhythm can beacquired over clothing, without the user needing to undress. Heartbeatand respiration rhythm based on scan data from the accelerometer has theadded advantage of allowing cross-correlation with other data streamsfrom other sensors.

FIGS. 1E and 1F illustrate the use of the microphones 875 in the scanner102 to capture body sounds around the chest 114, such as heart sounds155 and lung or breathing sounds 157. These body sounds may be recordedto capture another symptom of a user's medical condition. Body soundsthat are captured may also be used to judge the quality of the vitalsigns scanning process. The recorded body sounds may be stored locallyin the memory of the scanner and/or sent to the device 140 for storagewith the vital signs data of the same time and date.

Scan data captured by the scanner may provide person-specific biometricsinformation. Phase spaces (poincare plots) of accelerometric data canprovide an element of person-specific biometric data, an identificationlinked to person specific noise in the acquired signals. Using chaosmathematics and various analytic tools on cross-correlated oruncorrelated data streams from the human body, it is possible to obtainpositive identification of any user linked to each person specific noisein the acquired data signals. This noise originates in the numerousminor and major anatomical and functional differences between thevarious users. The noise being person-specific acts like electronicfingerprints of a user.

Referring now to FIG. 2A, a portable wireless multifunction device 104is illustrated that can execute the vital signs scanning application140. The portable wireless multifunction device 104 includes a textscreen 202, at least one function button 206, and a power button orswitch 207. The multifunction device 104 may display a plurality ofapplication icons on the touch screen 202. One of these icons may be thevital signs scanning application software icon 140.

Referring now to FIG. 2B, a block diagram of the personal wirelessdigital device 104 is illustrated. The portable wireless multifunctiondevice 104 may be a smart phone, a tablet computer, a portable musicplayer, or a wireless portable storage device, for example, that includea processor, a touch screen, and a memory from which applicationsoftware instructions may be executed.

As shown in FIG. 2B, the portable wireless multifunction device 104includes a touch screen monitor 202, one or more wireless radiotransmitters-receivers (wireless radios) 204A-204M coupled to theirrespective antenna 205A-205M, a processor 206, non-volatile memory 208,at least one function button 206, and a cover button 207 that can switchpower on to each electronic circuit within the portable wirelessmultifunction device 104. At least one of the wireless radios 204A-204Mare compatible with the wireless radio in the wireless vital signsscanner 102.

The portable wireless multifunction device 104 may further include acamera 214, a microphone 215, and a speaker 216 coupled to the processor206 as shown. Furthermore the portable wireless digital device includesa battery 210 coupled to the power button 207. Typically the battery 210is a rechargeable battery such that an external power source may becoupled thereto via an external power connector 211 and a charge circuit209.

Non-volatile memory 208 of the personal wireless digital device maystore the vital signs scanning application software 140 and data 220related to the vital signs scan application software. The processor 206can read and write to the non-volatile memory such that the vital signsscanning application software can provide a user interface to a user viathe touch screen display device 202. As discussed previously, theinitial vital sign scanning window 140I may be provided as shown in FIG.1C.

The camera 214 of the portable wireless digital device 104 may takephotographs of a user's conditions or symptoms via the photograph entrybutton 175 of the user interface. The photographs may be stored as partof the data 240 in the non-volatile memory. The microphone 215 in theportable wireless multifunction device 104 may optionally be used tocapture body sounds similar to the microphones in the scanner 102, as isshown in FIGS. 1E-1F.

The speaker 216 of the portable wireless digital device 104 mayoptionally be used to provide audible user feedback to the user of thevital signs scanner 102 to improve the vital signs scan quality as isdiscussed herein.

Referring now to FIG. 3A, an exemplary scanning window 140A is shownbeing displayed by the touch screen display device 202 of the portablewireless multi-function device 104. The scanning application software140 generates the various images consisting of a scanning progress bar310, a scanning icon 312, a first vital signs graph 314A, a second vitalsigns graph 314B, one or more result buttons 320, and one or more statusicons 324.

The status icon 324 may be a wireless connection status icon indicatingthat the portable wireless digital device 104 is connected to the vitalsigns scanner 102. The button 320 may be a results button to which toswitch to another scanning window/screen of a user interface provided bythe scanning application software 140. The scanning icon 312 may includethe plurality of color bars 312A-312E that randomly vary in color andlength to indicate that scanning is occurring. The scanning progress bar310 illustrates the progress of the scanning session being performed bythe portable wireless vital signs scanner 102. In this case data isbeing sent from the scanner 102 to the portable wireless multifunctiondevice 104.

Briefly referring back to FIG. 1C, the initial window 140A includes auser menu button 161 that may be used to display a users menu on how tooperate the vital signs scanner. The initial window 140A may further bechanged to a graph window to show plots of prior scan data stored in thedevice 104. A graph button may be provided to do so or a finger swipemay be used.

The first vital signs can be displayed in graph form over different daygranularity such as 1 day, 1 week, 1 month, 3 months, 9 months and 1year. Graphs may be electrocardiogram (ECG) graphs to illustrate theelectrical activity to show the user's heart rate or heart ratevariability. The waveforms displayed in the graphs are captured by thescanning process of the portable wireless vital signs scanner 102. Asecond vital signs graph may be oxygenation graph related tophotoelectric plethysmogram (PPG) from the data obtained by the pulseoximeter. The scanner captures a user's blood volume pulse of bothoxygenated and deoxygenated blood. From the photoplesmography waveforms(oxygenated and deoxygenated) a user's oxygen saturation can be obtainedand displayed in the oxygenation graph.

Referring now to FIG. 3A, a health status window/screen 140B of the userinterface software 140 is shown being displayed by the touch screendisplay device 202 of the device 104. The screen 140B includes a numberof similar items illustrated in screen 140A of FIG. 1B and are notrepeated here. The health status slider window/screen 140B (it can beslid sideways) includes a health status button 180, a health statuswindow 181. The health status slider window 181 includes a display of ahealth status question 182 to obtain further information from a user. Torespond, the health status slider window 181 includes a plurality ofselectable health status response indicators 183A. The user selects onewhich becomes highlighted over the others, such as health statusresponse selected icon 183B. The health status slider window 181 furtherincludes a health status selected response information 184, such as “InPain”, that is displayed to the user to confirm the selected healthstatus response.

Referring now to FIG. 3B, a scanning results window/screen 140C is shownbeing displayed by the touch screen display device 202 of the device104. The screen 140C includes a number of similar items illustrated inscreen 140A of FIG. 1C and are not repeated here. The exemplary scanningresults window 140C may be generated by the user after selecting aresults button under the menu button or by one or more sliding fingergestures (e.g., down and/or to the right).

The scanning results window 140C includes a results filter button 163D,and a calendar button 163. The scanning results window 140C displays oneor more scanning sessions 300 each including a completed scan typeindicator 301, an interpretive message indicator 302, a picture tagindicator 303, a date/time stamp 305, and a location time stamp 306. Thescanning session that is selected for display on the device 104 ishighlighted by a selected scan indicator 304. The scanning resultswindow 140C further displays a results information slider window 307 andslider number indicators 308.

Referring now to FIGS. 3B-3C, the results information slider window 307of the scanning results window 140C can be slid sideways by a user'sfinger to display different slides. As shown in FIG. 3C, the differentslides or windows displayed in the slider window 307 include a vitalsign measurements results slide 350, an interpretive message slide 351,a health status report slide 352, and a scan summary information slide353.

The vital sign measurements results slide 350 includes a plurality ofvital signs icons 333A-333F (collectively 333), a plurality ofassociated vital signs measurements 332A-332F (collectively 332), and aplurality of associated vital measured labels 331A-331F (collectively331). The vital measured labels 331 and vital signs measurements 332indicated in the slide may include heart rate 331B,332B; breathing(respiration) rate 331F,332F; temperature 331A,332A; blood pressure331C,332C; heart rate variability (HRV) 331E,332E; and blood oxygenation331D,332D. The associated vital signs icons 333 may include a heart icon333B, a breathing (lung) icon 333F, a thermometer icon 333A, a bloodpressure icon 333C, a variable heart icon 333E, and an oxygenation icon333D.

The actual measurements captured during the scanning process areillustrated by the numeric number values of the vital sign measurements332. For example, the heart rate measurement 332B of sixty-three (63) isshown near the heart icon 333B and the heart rate text label 331B. Thenumeric values of the vital measurements 332 may be the averagemeasurements captured during the scan that was immediately performedrecently or that scan session is selected by the user. The measurements332 are illustrated near their respective icons 333 and the respectivetext labels 331 indicating the vital sign that was measured. The resultsof the scan are typically automatically saved. However, a functionbutton may be required to delete those scan results from the wirelessportable multi-function device 104 or alternately a button to uploadthose results to a storage server.

The interpretive message slide 351 includes a medical informationdisclaimer 361, a medical interpretive message 362, and a learn morelink 363. The medical information disclaimer 361A in the interpretivemessage slide 351 may be a message such as “while this is not a medicaldevice, you should probably be informed of something we've noticed”. Themedical interpreter message 362 may be something such as “your systolicblood pressure is above the normal range, as indicated by the NationalInstitutes of Health, for someone of your age, gender, height andweight.” The learn more link 363 may include a selectable icon or textto transfer the user to a web browser and a health link where he maylearn more about his or her condition indicated by the medicalinterpreter message 362.

The health status report slide 352 includes health status responsebuttons 372. Health status response buttons 372 may include a symptomsbutton 372A to enter health symptoms, such as a headache or a cough forexample, when the scan was taken. A medication button 372C may be usedto indicate a vital signs scan was performed after taking medication. Asleeping response button 372B may be used to indicate the number ofhours of sleep for a night prior to performing the scan.

The scan summary information slide 353 includes a scan summary 381 of aselected scan session. The scan summary may include the time and datestamp 383A, the location 383B of the scan, the type of scan 383C (e.g.,head or chest), and the duration 383D of the scan, such as thirteen (13)seconds. The scan summary 381 may further indicate user biometrics 383Esuch as the gender, age, weight, and height of the user being scanned.The scan summary may further indicate whom 383F performed the scan, suchas the user or a family member. In the scan summary example in the scansummary slide 353 shown in FIG. 3C, the user Mimi was scanned by her Momon Aug. 14, 2013 at 8:29 AM in Campbell, Calif. The scan of Mimi was ahead scan having a duration of thirteen (13) seconds. Mimi's userbiometrics indicates she is five (5) years old, weighs forty-eight (48)pounds, and a height of three feet, six inches (3′, 6″).

FIG. 3D is an illustration of an exemplary window of the vital signsscanning application on the portable wireless device. In this exemplarywindow displayed on touch screen 202 of the multifunction device 104,the vital signs scanning application 140 is prompting the user to selecta second scan. A second scan may be selected by touching scan virtualbutton 342 or using a finger gesture on the touch screen. A third scanmay also be selected after the second by touching scan virtual button342 or using a finger gesture on the touch screen. The third scan may beperformed at the chest region to measure respiration rate and collectbody sounds. The user may desire to skip a secondary scan by touching askip scan virtual button 344.

Referring now to FIGS. 4A-4B, a temperature averaging window 140T isshown being illustrated in the touch screen 202 by the scanningapplication software 140. This may be displayed as a result of selectingthe graph button 165 of the initial scanning window 140I. Thetemperature averaging window 140T could include a textual heading 400illustrating the types of graph that are plotted below. The textualheading 400 may recite “seven-day average” to let a user know that oneor more seven-day average graphs are being displayed below. The portablevital signs scanner 102 may be used periodically throughout a 24-hourperiod each day. The seven day average may look back over a seven daywindow and time, plotting an average curve 401A, a maximum curve 401M,and a minimum curve 401S. The vital sign measurements are plotted on theY-axis 411 and a time as the time of day on the X-axis 410. The portablewireless vital signs scanner 102 is expected to be used daily atmultiple times during a day. In this, manner the vital signs of the userare captured periodically during the day by the vital signs scanner 102and the personal portable wireless device 104 of the scanning system100. The maximum curve 401M and the minimum curve 401S may beillustrating plots of the maximum value and minimum values over allscans that were previously performed. The time of day axis 410illustrates periodic time values during the span of a 24-hour day. Inone embodiment, the far most right point of the curves represents thegiven time of day 415 of a sliding window. In another embodiment, thetime axis is fixed and the curve 401A grows from left to right duringthe time period as scans are made and time actually progresses. The scanpoints 420A-420N are illustrated along the average curve 401A. The scanpoints 420A-420N may represent actual scans during the day or somemeasure of average during the preceding seven-day period. Interpolationlines 421A-421M may be inserted between each scan point to show a trendline of how the vital sign that is measured varies during times of theday. For example, scanning point 420J may represent a scan that tookplace between 4:00 and 7:00 pm and how the body trends towards thatduring that time of day.

The illustrated seven day average graph illustrated in FIGS. 4A-4B showsa body temperature graph. This is for illustration purposes only. Thevital sign measurement curves could be temperature curves, bloodpressure curves, oxygenation curves, heart rate curves,breathing/respiration rate curves, for example, that representmeasurements that are scanned by the vital signs scanner 102.

As more information is captured by the scanner 102 and stored in thepersonal portable multi-function device 104, additional results may beplotted over time to generate the vital signs curves for display by anaveraging window, such as vital signs window 140T.

Referring now to FIG. 5A-5E, a plurality of prognosis windows 140D-140Hare illustrated. In FIG. 5A, the heart rate prognosis window is shown.In FIG. 5B, the temperature prognosis window 140E is illustrated. InFIG. 5C, a breathing rate prognosis window 140F is illustrated. In FIG.5D, a blood pressure prognosis window 140G is illustrated. In FIG. 5E, ablood oxygenation window 140H is illustrated. These windows may beselected through the use of the vital signs icons 333A-333E acting asbuttons to display the respective prognosis window.

As illustrated in FIG. 5B, each prognosis screen 140D-140H, may includea navigation bar 502, one or more function buttons 503, a vital signsicon 504, a return button 505, a conditions indictor 506, a vital signsindicator 507, a measurements value indication 508, and a vital signsbar 510. The navigation bar 502 may allow a user to navigate the variousscreens of the vital signs application scanning software 140. Forexample, a scan screen icon/button 521 may be provided to jump to thescanning screen. A prognosis screen icon/button 522 may be provided tojump to the prognosis screens 140D-140H.

The vital signs bar 510 may be provided to navigate through the variousvital signs prognosis windows/screens 140D-140H as well as providing asnapshot of the values of each of the vital sign measurements. In thatcase the vital signs bar 510 includes a measurement value indicator 512and a vital signs icon 511 for each of the vital signs that are scannedand captured by the vital signs scanning system 100.

The return button 505 may be used to return to the previous screen thatwas displayed by the user interface of the scanning application software140. The function button 503 may be an add a note button to add textabout a user's condition or circumstances under which a scan was taken.The vital signs icon 504 indicates at a glance what prognosis window isbeing displayed.

The conditions indictor 506 for each prognosis screen will provide anindication of the most recent scan in comparison with an expectedaverage value for a given user. For example, a temperature's vital signis illustrated in FIG. 5B as having the condition indication of high dueto a measured value of 101° F.

In the vital signs bar 510 the measurement indicator 512 and the vitalsigns icon 511 may be highlighted to indicate which prognosis screen isbeing illustrated at a glance.

Referring now to FIG. 6A-6D, respective use of the portable wirelessvital signs scanner 102 are illustrated. In FIG. 6A, a top frontperspective view, the wireless vital signs scanner 102 includes a frontelectrode 610, and a front sensor 612 on a front side. The frontelectrode 610 is pressed against the user's forehead/temple, preferablyat the temple, in order for the scanner 102 to make an electricalconnection to the body of the user.

In one embodiment the scanner 102, a top sensor window 621 and a topelectrode 622 are provided in the topside of the scanner 102. A topsensor 121 may be located underneath the top sensor window 621 to obtaina vital signs measurement from a user's finger that may be pressed ontop of the window 621. A top electrode 622 may be used to form anelectrical connection to a user's finger and complete a circuit of theuser's body such as illustrated in FIG. 1A.

The housing 600 of the vital signs scanner 102 may generally be circularshaped and include a circular top housing 620G, a circular bottomhousing 620B, and a hollow cylindrical surface 620S. The sidecylindrical ring 620S may be concave, or convex over a portion of thesurface. Alternatively, the cylinder side surface 620S may be a toroidshape over a portion of its body.

In FIG. 6B, a top back perspective view of the wireless vital signsscanner 102 is illustrated. The wireless vital signs scanner 102illustrate various aspects of the invention in the side cylindricalsurface 620S. The wireless vital signs scanner 102 includes a powerbutton 613, a serial port connector 614, an optional wireless connectionLED 618, and a power light-emitting diode 616. The power button 613 maybe pressed to power the wireless vital signs scanner 102 on. The serialport connector 614 may be a micro universal serial bus connector toallow a micro USB cable to plug thereto. The micro USB port may providean external power source to charge the rechargeable battery within thewireless vital signs scanner 102 and also may serve as a wired data portfor updating firmware or transferring data to a computer or storagedevice. The optional wireless connection light-emitting diode 618provides a visual indicator that the wireless vital signs scanner 102 iscoupled to the wireless personal portable multi-function device 104 overits wireless communications channel 103A as illustrated in FIG. 1A. Thepower light-emitting diode 616 provides an indicator that the wirelessvital signs scanner is powered on by the power button 613.

In FIG. 6C, a vital signs wireless scanner 102′ is illustrated having agenerally diamond shaped body housing 620. In this case the housing top620T and the housing bottom 620B generally have a diamond or a squareshape to match that of the side cylindrical surface 620S. The top orbottom housing portion 620T may each include a gripping surface 624 withcorrugations or channels so that a user may comfortably and securelyhold the wireless vital signs scanner 102′. The gripping surface 624 maybe formed of a conductive material to aid the top and or bottomelectrodes in forming an electrical connection to a user's body.

Referring now to FIG. 6D, a top front perspective view of the wirelessvital signs scanner 102′ is illustrated. The wireless vital signsscanner 102′ includes the front electrode 610 and front sensor 612.

While the electrode 622 and the gripping surface 624 are illustrated inthe top housing 620T, they may also be implemented in the bottom housingportion 620B instead of the top. Instead of an index finger making aconnection with a top electrode 622, a thumb finger may couple to abottom electrode (not shown) to provide a larger surface area contact tothe body in the bottom housing portion 620B.

Referring now to FIG. 7A, an exploded view of the wireless vital signsscanner 102 is illustrated. The exterior components of the wirelessvital signs scanner 102 are formed of parts that can be wiped clean by adamp towelette or a disinfecting wipe. In this manner, the scanner 102may be shared by users in a family with less worry about spreadingbacteria and germs. Each user may have a personal profile or preferencesstored in the scanning software application 140.

The wireless vital signs scanner 102 includes a main printed circuitboard 701A and a daughter printed circuit board 701B coupledperpendicular to the main circuit board 701A. Because the scanner 102 iswireless, it includes a rechargeable battery and a connector port towhich a cable may connect to recharge the battery. Preferably thebattery may be charged in an hour or less. If the scanner 102 is used afew times a day, the charge of the rechargeable battery may last about aweek. The main print circuit board 701A, the daughter printed circuitboard 701B, and the rechargeable battery form an electronic sub-assembly701.

The electronic sub-assembly 701 is inserted into a housing 702 of thevital signs scanner 102. The sensors on the front daughter board 701Bare aligned into a front sensor opening 710 in the side housing ring702C of the housing 702. A ribbon cable 720 electrically connects thefront daughter board 701B to the main print circuit board 701A. A sensor812 in the front daughter board 701B includes electrical leads that arecoupled to the main printed circuit board 701A.

The main printed circuit board 701A is inserted into the housing ring702C so that a serial bus connector 612 aligns with the connectoropening 722 and the front sensor 812 is aligned into the front sensoropening 710. A top/bottom electrode 806B covers over an opening 704 andis electrically coupled to the main printed circuit board 701A and anECG circuit mounted thereto.

The housing 702 of the wireless vital signs scanner 102 includes a tophousing portion 702T with a top electrode 806B, a side housing ring702C, and a base housing portion 702B. The orientation of the housing702 for the scanner 102 may be altered such that the housing base 702Bbecomes the housing top 702T and the housing top 702T becomes thehousing base 702B with a bottom electrode 806B to couple to a thumb.Electrodes may also be in both the housing base 702B and the housing top702T to provide a lower resistive coupling to the user's body.

The top housing portion 702T includes a microphone opening 717T and aplurality of posts 725 and an electrical sensor opening 704. The housingbase 702B may include a microphone opening 717B and a plurality ofpillars 726 that can interface to the posts 725 when the housing isassembled together about the printed circuit boards.

The wireless vital signs scanner further includes a front cover 711 tofill in the front sensor opening 710 in the side housing ring 702C. Thefront side cover 711 includes a plastic cover portion 712 and a frontelectrode portion 727 with a lens 715 transparent to thermal wavelengthsto allow the sensor 812 beneath it to capture a measure of temperature.The plastic cover 712 is also transparent to various wavelengths oflight that are used by the vital signs sensors. The front electrodeportion 727 of the front cover 711 is formed of a conductive material,such as stainless steel metal, to form a circuit when pressed up againstthe user's body at the forehead/temple, finger, chest or elsewhere. Theshape of the front electrode 727 can vary with the shape of the wirelessvital signs scanner 102.

The side housing ring 702C includes one or more LED openings 712 toreceive the power light-emitting diode 616 and the optional wirelessconnection light-emitting diode 618. The side housing ring 702C furtherincludes a power button opening 723 through which the power button 613may extend.

FIG. 7B illustrates a partially assembled wireless vital signs scanner102. Through the front opening 710 in the side housing ring 702C, thefront daughter printed circuit board 701B includes a slot opening 721.The slot opening 721 may be used to receive a shade 708 that separatesthe LEDs 808A-808B from the photo diode 810. The shade 708 deters lightemitted by the LEDs 808A-808B from directly being impinged onto thephoto diode 810. The wire (not shown in FIG. 7B) from the frontelectrode 727 may inserted through the opening 706 and then coupled tothe main PCB and the ECG circuit. The front cover 711 can then assembledto cover over the front opening in the side housing ring 702C of thehousing.

The daughter printed circuit board 701B is arranged to be substantiallyperpendicular with the main printed circuit board 701A. As previouslydiscussed, the front cover 711 includes a transparent cover portion 712and a metallic conductor portion 727, and the lens 715. The transparentcover portion 712 covers over one or more light-emitting diodes808A-808B generating various wavelengths of light, and a photo diode 810that receives various wavelengths of light. The light generated by thelight-emitting diodes 808A-808B is shined onto the user'sforehead/temple and reflected back to the photo diode 810. Light withknown time periods may be generated by the light emitting diodes (LEDs)808A-808B with different wavelengths and radiated onto a user'sforehead/temple. The reflection is detected by the photo diode 810 toform an electrical signal that is analyzed. In this analysis of thesignal generated by the reflected lights of different wavelengths, ameasure of oxygenation in the blood stream may be generated.

The front side cover 711 includes the transparent lens 715 with a centeraligned into the optical axis of the front side sensor 812 so thatadditional vital signs measurement may be made from the forehead/templeof the user. An opening 706 in the daughter board 701B allows a wire topass through from the front electrode 727 and be coupled to a wire traceon the main PCB that is coupled to the ECG circuitry mounted thereto.When pressed against the user, the metallic electrode portion 727 of thefront side cover 711 makes an electrical contact to the forehead/templeor other body portion of the user. An insulating ring 736 under theelectrode portion 727 of the front side cover may be used to isolate anymetal of the infrared thermometer 812 from the electrode portion 727.

FIG. 8A illustrates a functional block diagram of electronic circuitry800 within the portable wireless vital signs scanner 102. The personalportable wireless vital signs scanner 102 associated with a given userprofile stored in the user data of the wireless personal multifunctiondevice 104. The wireless communication channel 103A between the scanner102 and the multifunction device 104 may be a secure connection withinformation passed between each. The devices are typically paired toeach other by a code so that no other wireless device may utilize thewireless communication channel 103A. A different wireless communicationchannel 103B may be generated between the vital signs scanner 102 and apersonal computer 150, for example. Each of the wireless communicationchannels 103A, 103B may be a Bluetooth communication channel, forexample, in which case the signal strength between each over a Bluetoothcommunication channel is relatively short with a limited distance over arange between zero and twenty-five feet, for example.

Referring now to FIG. 8A, electronic circuitry 800 of the portablewireless vital signs scanner 102 includes a processor 840 at the heartof the system. The processor 840 may be a reduced instruction setprocessor operating with embedded operating system software. In oneembodiment of the invention, the processor is an ARM processor operatingwith MICRIUM's embedded real time operating system (RTOS).

To provide the wireless communication channels 103A, 103B, a wirelessradio 870 is coupled to the processor 841. The wireless radio 870 iscoupled to an antenna 871 that could be internal, as part of an overallradio system, or external to the wireless radio 870. An optional lightemitting diode 848, used as a wireless connection indicator, is coupledto the wireless radio to indicate a successful pairing with the personalportable wireless digital multifunction device 104. To scan for vitalsigns over a period of time such as 10 seconds, the electronic system800 includes an infrared thermometer 812, an accelerometer 885, a pulseoximetry sensor and a pulse oximetry circuit 880, and analogelectrocardiogram circuitry 860. Coupled to the electrocardiogramcircuitry 860 is the bottom or top electrode 806B, the front electrode711, bottom/top electrode connection, and the front electrode connection806F. As shown in FIG. 1A, a portion of a human body is coupled to thefront electrode 711 and the top/bottom electrode 806B to form a circuit.

The pulse oximetry circuit 880 is coupled to a pair of light emittingdiodes 808A-808B. Each of these emit light patterns that are reflectedoff of the user's forehead/temple internally. The reflected light iscaptured by a photodiode 810 and coupled to the circuit 880. That is,incident light 891 from the light emitting diodes 808A-808B reflectsinternally off the user's head 116 as reflective light 892 which isreceived by the photodiode (PD) 810.

The infrared thermometer 812 detects the surface temperature of a use'sforehead/temple (or elsewhere) by measuring thermal radiation (referredto as Blackbody radiation) 813 emanating from the head 116 (or otherbody portion to which the scanner is pressed) of a user.

To power the circuits in the system 800 of the personal portablewireless vital signs scanner 102, a rechargeable battery 850 and avoltage regulator and battery charge controller 854 are coupled togetherinto the circuits in the system 800 when the switch 852 is closed. Thebattery charge controller 854 is coupled to power pins of a serialconnector 856 to receive an external DC voltage supply. The externalvoltage supply may be used to recharge the battery and power the system800 when it is connected. The rechargeable battery 850 may hold a chargefor a period of seven days, even while scanning multiple times duringeach day, due to the low power consumption of the circuitry and thelimited period of time needed to perform a scan of the vital signs of auser. That is, the vital signs scanner 102 is not expected to becontinuously powered on during a day, but powered up periodically toperform the scans as needed.

The processor 840 may include a processor memory 841 to store systeminstructions to control the circuitry in the system to obtain the scansand process the information obtained through those scans into a properuser format. To store the user data from each of these scans, anonvolatile memory 844 is coupled to the processor 840. The nonvolatilememory 844 may be soldered to a printed circuit board with the processor840. In an alternate embodiment of the invention, a connector 845 isprovided so that the nonvolatile memory 844 is a removable memory cardso that a user's data may be transferred from one scanner to the next,if needed.

A power LED 851 may be coupled to the processor 840 to provide anindication that the electronic system 800 is powered up. The system canbe manually shut down via the scanning software application 140 so thatthe scanner 102 powers off. However, the scanner 102 can alsoautomatically shut off after a predetermined period of time to conservepower and a charge on the rechargeable battery 850. The user then justneeds to press the power switch 852, once again, to turn the system backon and scan for vital signs of a user.

The processor 840 includes one or more analog digital convertors 842 inorder to receive analog signals from the infrared thermometer 812,accelerometer 885, pulse oximetry circuits 880, and ECG analog circuits860. Electronic system 800 may further include a stereo microphone 875consisting of a top microphone 875T and a bottom microphone 875B eachcoupled to a stereo microphone amplifier 874. The stereo microphoneamplifier may have its own analog to digital converter, or theprocessor's analog digital convertor 842 may be used to convert analogsignals into digital signals. For example, an ECG analog signal may beconverted into digital signals with the analog digital convertor 842 ofthe processor. The stereo microphone 875 captures audio signals near thewireless vital signs scanner 102. The accelerometer 885 capturesmovement of the portable wireless vital signs scanner 102.

The combination of the audio information and the movement informationmay be utilized to determine the quality of the scanning informationbeing obtained by the vital signs capturing circuitry. For example, thestereo microphone 875 may be used to capture noise from a user talkingand plot that on a graph indicating noise spikes, or noise lines 330,such as shown in FIG. 3A. This provides feedback to a user about thequality of the scan at these intervals. The accelerometer 885 and themotion information may be similarly used to make a judgment about thequality of the vital signs scanned information being captured by thevital signs circuitry of the infrared thermometer 812, the pulseoximetry circuits 880, and the ECG analog circuits 860.

The microphones 875 in the portable wireless scanner 120 may also usedto capture body sounds such as shown in FIGS. 1E-1F and store thecaptured body sounds in memory 844 as a potential symptom of a medicalcondition of the users body. For example, heart beat sounds 155 may becaptured by the microphones 875 when the scanner 102 is positionedagainst skin of the chest 114 near ones heart 156, as is illustrated inFIG. 1E. As another example, lung or breathing of air entering andexiting ones lungs, respiration sounds 157, may be captured by themicrophones 875 when the scanner 102 is positioned against skin of thechest 114 near a lung 158 in ones body, as is illustrated in FIG. 1F.

To further optimize scanning results, scan quality algorithm monitor thevita signs scanning process and can provide feedback (visual and/oraudible) to the user, such as through the multifunction device 104.

An optional audible sound generator 847 in the scanner 102 may becoupled to the processor 840 to provide audible user feedback to theuser during the scanning process. The user feedback may help the user toperform better vital signs scan with the wireless vital signs scanner102 and acquire a higher quality of vital signs measurements. Theaudible sound generator 847 may generate alert sounds indicating whenthe scanning process begins and ends. It may also generate an errorsignal indicating to the user that he is not properly using the scanner102 and look for instructions on the device 104.

Referring now to FIG. 8B, a block diagram of the electronic circuits 800is shown mounted onto the main printed circuit board 801A and thedaughter printed circuit board 801B. FIG. 8B also illustrates alternatelocations for electronic circuits in the system 800 for alternateembodiments of the vital sign scanners 102, 102′.

A slot 803 in the daughter printed circuit board 801B receives a shadedevice 708. Light emitted by the LEDs 808A-808B is shaded by the shadedevice 708 so that it may not directly impinge onto the photo diode 810in the daughter PCB 801B. Reflected light, reflected off the user'sbody, is desirable to be captured by the photo diode 810.

Wire leads 830 of the IR sensor 812 and the front electrode contact 806Fare coupled to pads 831 of the main printed circuit board 801A. Firstand second LEDs 808A-808B and the photodiode 810 are coupled toconnector 821 by conductive traces 819B on the daughter printed circuitboard 801B.

The main printed circuit board 801A has a plurality of wire traces 819Acoupling circuits mounted thereto together. The daughter printed circuitboard 801B includes a plurality of traces 819B coupling circuits mountedthereto to connector 821. A ribbon cable 820 is used to couple signalsbetween the daughter memory card 801B and the main printed circuit board801A for the oximetry circuit 880. The oximetry electronic circuit 880is coupled between the connector 822 and the processor 840 on the mainprinted circuit board 801A. One set of one or more wire traces 819Acouple the oximetry electronic circuit PPG 880 to the connector 822.Another set of one or more wire traces 819A couple the oximetryelectronic circuit PPG 880 to the processor 840.

In accordance with one embodiment of the invention, if the oximetrysensors are moved to a top portion of the housing to sense oximetrythrough a finger, with the IRLEDs 801A′-801B′ and the IR photodiode810′, the oximetry circuitry may be moved to the opposite side as theoximetry electronic circuit PPG 880′ coupled between the processors 840and the LEDs 808A′-808B′, IR photodiode 810′ and mounted in the topportion of the housing.

The bottom or top electrode 806B is formed of stainless steel to providea good connection to either a thumb finger or an index finger. Theelectrode 806B is coupled to a connector 823 and to the ECG circuitry860 on the main printed circuit board 801A.

The main printed circuit board 801A includes the processor 840, thewireless radio 870, the microprocessor memory 841 (either internal orexternal as shown mounted to the printed circuit board), anaccelerometer 885, an amplifier 874, oximetry circuitry 880, 880′, usermemory 844, and battery charge circuit 854.

Top and bottom microphones 875T and 875B extend out from the mainprinted circuit board 801A by ribbon cables so that they may be mountedinto the respective openings in the housing top and housing bottom. Themicrophones 875T, 875B may be coupled to the amplifier 874 which in turnmay couple audio signals into the microprocessor 840. Mounted to themain printed circuit board is the power LED 851 and the connection LED848. Further mounted to the main printed circuit board is a power on/offswitch 852 coupled to the voltage regulator battery charge circuit 854to signal for it to turn power on or off to components with the scanner102. Additionally, mounted to the main printed circuit board 801A is aserial connector 856 coupled to the microprocessor. In one embodimentinvention, the serial connector 856 is a micro universal serial busconnector.

An optional audible sound generator 847 may be mounted to the main PCB801A and coupled to the processor 840 as shown. To avoid interference,the sound generator 847 may be positioned away from the microphones 875.

Main printed circuit board 801A includes a plurality of openings 826that receive the pillars 725, 726 of the housing top 702T and housingbase 702 B.

The daughter printed circuit board 801B includes a connector 821, lightemitting diodes 801A-801B, and a photodiode 810 mounted thereto. The IRsensor 812 is inserted through a hole in the daughter PCB 801B, attachedthereto with an adhesive, and supported thereby. The front electrode806F around the IR sensor 812 is attached with an adhesive to thedaughter PCB 801B for support.

The ribbon cable 820 couples signals of the light emitting diodes801A-801B and the photodiode 810 regarding oximetry between the daughterboard 801B and the main printed circuit board 801A for the oximetrycircuit 880. With the terminals 830 of the IR sensor 812 coupled to thepads 831 of the main PCB 801A, signals of the IR sensor 812 regardingtemperature are coupled into the processor 840. With the terminals 830of the front electrode 806F coupled to one or more pads 831 of the mainPCB 801A, signals of the ECG circuit 860 to measure heart activity(e.g., heart rhythm, heart rate, etc.) may be coupled into and out of ausers body.

Thus, the personal portable wireless vital signs scanner integrates aplurality of sensors and a controller/processor together tosynchronously obtain a plurality of vital signs at different timesduring a users day. Despite the integration of multiple sensors and acontroller/processor into the scanner, the vital signs scanning devicehas a relatively low production cost. The integration with a ubiquitousconsumer electronic device pre-owned by many users, the personalwireless multifunction device (e.g. smartphones, tablets, etc.), todisplay the vital signs data with vital signs scanning software, alsokeeps the costs low of the overall personal vital signs scanning system.The low costs of production of the vital signs scanner can allow lowerretail pricing and higher volume of sales, enabling an average consumerto afford the vital signs scanning system to personally scan and monitortrends of their vital signs for as an important part of preventivemedical care of their own bodies.

Referring now to FIG. 9, a diagram illustrating an exemplary hierarchyof windows provided by the scanning application software 140 isillustrated. A variety of vital sign scanning user interface windows ofthe scanning application software 140 have been described. The vitalsigns scanning application software 140 executed by a processor providesa user interface hierarchy of the vital sign scanning user interface(VSUI) windows. For example after the vital sign scanning application isopened at process 900, a scanning login button 902 may be presented tothe user by the scanning application software 140. If the user isproperly selected he chooses the login button to transition to a userhome screen 140H.

In the user home screen 140H, a user inputs his login identification andpassword to gain access to personal vital signs scan data stored in thedevice 104. If the user is a different user a different user button 903may be selected or a horizontal swipe finger gesture 940H may be used togo to a select user window 140L. If the user is not listed and is a newuser, the select user window 140L may have a new user button 905 thatjumps to a new user window 904U that is displayed to the user.

In the new user window 940U, the new user may input his login user IDand password that he desires to use with the scanning softwareapplication to identify his personal vital signs scan data. Otherinformation, such as sex, height, weight associated with a time and datemay be entered by the user. As the days and/or years go by, the user mayupdate this information in the profile so that the vital signs scanningsystem better knows what conditions might occur for the given user. Thelogin and profile windows can also allow the scanning system to beshared with other users in a family. After logging in with user ID andpassword through the home screen, the scanning system application maydisplay the initial scanning window 140A.

By using a horizontal finger gesture 940H over the scan type slider 171,the user may select a head scan 173A, a chest scan 173B, the resultswindow 940RW (e.g., windows 307,350-353 in FIGS. 3B-3C, windows140D-140H in FIGS. 5A-5E)), or the graphs window 940GW (e.g., window140T shown in FIGS. 4A-4B). If at any point in time the user feels theneed to terminate the scanning process, the done button 190 in the userinterface may be selected. By means of a vertical finger gesture 940V inthe scanning window 140A during a head scan 173A or chest scan 173B, orthe results window 940RW, the health status window 140B may bedisplayed. Alternatively, a health status button 180, such as shown inFIG. 1C, may be selected to display the health status window 140B.

Each of the screens/windows/slides of the vital signs scanningapplication may be navigated by pressing one or more virtual graphicalbuttons (e.g., back, done) and/or making one or more finger gestures940F (e.g., vertically up/down 940V, horizontally left/right 940H)dragged across a touch screen. A navigation bar may alternatively beprovided with navigation buttons to navigate between selected windows.The menu button may also be used to navigate to different windows. Inother cases, pressing a button displays a different screen/window/slidesuch as the done button.

After scanning is completed, the scanning application software canautomatically display the results window 140RW. Additional buttons inthe results window 140RW may be used to navigate to various graphwindows 140GW, such as the temperature graph window shown in FIGS.4A-4B. Additional buttons in the results window 140RW may be used tonavigate to various prognosis windows, such as prognosis windows140D-140H shown in FIGS. 5A-5B. In this manner, vital signs data andinformation can be displayed to the user in various ways.

The scanning software application 140 includes a number of instructionsand routines that are executed by a personal wireless multifunctiondevice 104. The personal wireless multifunction device 104 may include asmart phone, an APPLE IPHONE 5, IPHONE 4S and SAMSUNG GALAXY S III thatsupport Bluetooth Smart. To help everyone use the device, assistivetechnology may be added to the scanning software application 140.

The significant software routines of the scanning software application140 include a scan procedure controller based on scan quality algorithm,UI implementation, wide area network interfacing to cloud services, scanresults interpretation, and trend charting.

Interactive Scanning and Quality User Feedback

The forehead and temple (forehead/temple) of a user has been identifiedas place to concurrently acquire multiple vital sign measurements of auser's body over a period of time (e.g., a ten or thirty second scan).The relatedness in time between the multiple vital sign measurementsallows them to be use together to determine scan quality. The scannerhas integrated sensors for concurrent data capture, making the scannermore capable than a single sensor alone, not only for multiple vitalsigns measurements but also for quality feedback regarding data capture.

There are a number of operating conditions that may not provide optimalscan data and scan results when the portable vital signs scanner 102 isscanning. If these operating conditions can be avoided, the scan dataand the scan results obtained therefrom can be improved. It is desirableto provide vital sign scan quality control for a better user experience.It is desirable to provide vital sign scan quality feedback to a user.The multiple sensors in the vital signs scanner 102 that concurrentlyacquire data enable a vital sign scan quality control. Integrated userinterface devices (e.g., sound generator 847) in the scanner 102 and thevital signs user interface 140 provided by the portable multifunctiondevice 104 and the software executed therein may provide an interactivescanning process to improve the user experience during a vital signsscan.

User feedback regarding the quality of a scan, quality feedback, can beprovided in real time by the scanner 102 and the vital signs userinterface 140 provided by the device. For example, a text message couldbe displayed or a voice message could be audibly generated such as“Please hold the scanner still for good scan” if the user's hand isdetected to be shaking it. A text message could be displayed or a voicemessage could be audibly generated such as “Please touch the scanneragainst your forehead/temple to start scan”, for example, if feedbacksuggest that the scanner is not touching the forehead/temple of theuser.

Quality feedback can be provided by fusing motion detection of thescanner and individual evaluation of signal deviation of each vital signsensor data from an expected normal range. There are three generalobservations that can be made into an algorithm regarding data capturequality in the portable vital signs scanner: 1) Significant motion fromthe accelerometer indicates that the data capture of ECG and Pulseoximetry data will not be good; 2) The signal quality from ECG, Pulseoximeter and IR thermometer sensors are independently evaluated; and 3)For high-quality data capture, data from all vital sign sensors shouldbe good.

Referring now to FIGS. 10A-10B, sounds and movement of a user's head mayaffect the quality of information that can be captured by the vitalsigns scanner. In FIG. 10A, a user is talking and moving his mouth 1001while holding the vital signs scanner 102 against his forehead/temple116. The movement of the users mouth can create vibrations that maydisturb the electrical connections between scanner and body as well asthe infrared scans between the vital signs scanner 102 and theforehead/temple 116 of the users head. The microphone 875 in the vitalsigns scanner 800 can help detect people talking during forehead/templescan.

Referring now to FIG. 10B, a user may also shake his head andforehead/temple 116 left and right as shown by the left and rightarrows, such as when talking with another or lacking in attention. Auser may also nod his/her head and forehead/temple 116 up-and-down asshown by the up and down arrows, such as when talking or lacking inattention. The movement of a user's head and forehead/temple can alsocause the vital signs scanner 102 to unreliably record vital signs data.

Referring now to FIGS. 11A-11C, the degree to which the vital signsscanner 102 is pressed against the user's forehead/temple 116 can alsoaffect the reliability of the data recorded by the vital signs scanner102.

In FIG. 11A, the vital signs scanner 102 does not touch theforehead/temple 116 of the user, making no contact, and thus the scannercannot complete a circuit with the body or reliably detect temperature.Scan data captured by the vital signs scanner 102 in this case would notbe valid.

In FIG. 11B, the vital signs scanner 102 only lightly touches theforehead/temple 116 of the user being too gentle such that a poorcontact is made between the vital signs scanner and the user's body. Theelectrical connection between the forehead/temple and the vital signsscanner is overly resistive. The angle the infrared scanner makes withthe skin of the users forehead/temple is not substantiallyperpendicular. In this case, the vital signs data captured by the vitalsigns scanner are poor and unreliable.

In FIG. 11C, the vital signs scanner 102 is pressed overly hard againstthe user's forehead/temple 116. In this case, the vital signs scanner102 may be pressed too hard against skin causing it to bulge inward awayfrom the sensors/contacts and/or cut off blood circulation in a veinunderneath the sensors. With reduced skin contact, the electricalconnection between the forehead/temple and the vital signs scanner maybe overly resistive and the ECG scan data may be poor or invalid. Adistance the infrared scanner makes with the skin of the user'sforehead/temple may be overly large such that poor temperaturemeasurements may be made. With reduced blood circulation underneath thepulseOX sensor, the pulseOx scan data may be poor. In this case, thevital signs data that is captured by the vital signs scanner is poor andunreliable.

It is desirable, to provide an interactive scanning system with userfeedback. When the vital signs scanner 102 is being improperly utilized,user feedback may be provided so that the user can alter his/her mannerof using the vital signs scanner 102 so that better data quality isachieved to enable reliable vital signs data capture.

As shown in FIG. 8A, The vital signs scanner 102 includes a processor840 and a memory 841,844 to store software program instructions forexecution by the processor. The software program instructions mayprovide an interactive scanning process and user feedback (with orwithout the digital device 104 and its scanning user interface) toimprove the quality of scanning data and results.

The microphone 875 in the vital signs scanner 800,102 may be used todetect the sounds of a human body to determine new vital sign values orinformation when placed at an appropriate body part, for example, neckor chest. The audio samples can be analyzed for and detect specificsounds of the human body. The information obtained from the sounds maybe fused together with other data to determine a new vital sign value ora diagnosis of a user's body. The microphone 875 may optionally be usedto detect sounds of a user talking during a forehead/temple scan, forexample, to aid in improving the quality of vital signs measurements andvital signs data.

The scanner 102 includes an accelerometer 885. The accelerometer 885senses acceleration due to the movement of the scanner. Theaccelerometer 885 can be used to improve the quality of vital signsdata. For example, the accelerometer 885 in the vital signs scanner 800,102 can be used to detect movement of the users head and forehead/temple116 that is to contact the scanner. The accelerometer is preferably athree-axis accelerometer measuring acceleration (in units of gravity g)in three orientations generating three acceleration output signals. Withthree-axis accelerometer information, the orientation of the scannerwith respect to earth and user can be determined in the typical scanscenario. The three-axis accelerometer information can help determinewhether the user is using the scanner properly. To measure the totalacceleration without knowing the specific orientation of theaccelerometer in the scanner, the square root of sum of squares (RSS)formula may be applied to all three outputs to form a singleacceleration measurement of the scanner. As the gravitation force(g-force) at the surface of the earth is typically one (1) g (9.80665meters per second squared), the relative acceleration of the scanner 102may be determined by simple comparison of the single accelerationmeasurement with earth's surface gravitational force of one g.

The measured relative acceleration by the accelerometer 885 may becategorized into relative degrees of motion based on the results of thecomparison earth's gravitational surface force of one g. The relativedegrees of motion that may be detected by the accelerometer 885 and thevital signs scanner 800, 102 are still (also referred to as no motion)1217S, small or minor motion 1217M, and big or significant motion 1217B.Significant or big motion 1217B may be on the order of one tenth g (0.1g) or greater deviation from one g (1 g), for example. Small or minormotion 1217M may be on the order from two hundredths g (0.02 g) up toone tenth g (0.1 g) deviation from one g (1 g), for example. Still or nomotion 1217S may be a smaller deviation on the order of less two tenthsg (0.02 g) deviation from one g (1 g), for example.

The detected motion by using the relative acceleration by theaccelerometer 885 can be combined or fused together with the sensor datafrom the vital sign sensors to be a collaborative decision regarding thequality of vital signs data during a scanning session by the user.

One of a user's fingers not only serves to hold and support the scanner102, but also as one contact point for the ECG circuit 860 (the otherone-lead ECG contact point is forehead/temple). The ECG circuit 860 andits electrodes 711,806F,806B may be used to determine how well(resistivity) an electrical contact is formed with the forehead/templeand finger of the user's body during the scanning process over a periodof time.

Scan data from the PPG sensor and/or the ECG sensor and their respectivecircuits may also be used to determine scan data quality. If the PPGscan data is off scale (saturated), then it provides an indication thatthere is no or too loose of a contact of the scanner 102 with a users'skin. If there is no PPG scan data signal but a good ECG scan datasignal is present, this provides an indication that too much pressurebeing is applied and hence no pulse recording is possible to generatePPG scan data. Accordingly, the ECG scan data and the PPG scan data canbe checked in this manner, fusing together the outcome to determine ifan appropriate amount of pressure is being applied to the scanner topress it against the user's body to obtain quality scan data for ECG andPPG measurements.

The vital signs scanning user interface 140 executed by the portabledigital device 104 is used to provide user feedback on its touchscreendisplay device 202 or its speaker 216. The user uses one hand to holdthe vital signs scanner 102 while his/her other hand holds the portablewireless device 104 (e.g., a smartphone) to view the touchscreen displaydevice 202. Alternatively or additionally, the audio sound generator847, a speaker, in the vital signs scanner 102 may be used to provideuser feedback.

User feedback may also be visually provided to a user by use of textmessages on the display 202 of the device 104 during the interactivescanning process and data acquisition by the scanner 102. User feedbackmay also be visually provided to a user by use of color coding on thedisplay 202 of the device 104 during the interactive scanning processand data acquisition by the scanner 102. For example, the color code ofgreen on a field or an object in the user interface can indicate thatthe proper amount of pressure is being applied to the scanner to pressit against the user's body. A color code of red on a field or an objectin the user interface, for example, may indicate that too much pressureis being applied to the scanner to press it against the user's body. Acolor code of yellow on a field or an object in the user interface, forexample, may indicate that not enough pressure is being applied to thescanner to press it against the user's body.

Referring now to FIG. 12, a functional block diagram of an exemplaryinteractive vital signs scanning control system 1200 is illustrated. Thevital signs scanning control system 1200 is a quick screening processbefore measurement are taken to decide in advance if a scan of vitalsigns data would be good, poor, or invalid. The screening processevaluates one or more short screening windows of time (e.g., WT1,WT2) todetermine the quality of vital signs data that is being captured. Theone or more short screening windows of time may be on the order of asecond or two for example. Assuming a one second window and a samplingrate or frequency of 500 Hertz (Hz) or a two second window and asampling frequency of 250 Hz, 500 data samples are used for thescreening process. After the initial screening process provided by theinteractive vital signs scanning control system 1200 determines thatgood signal data is being captured, a valid vital signs data captureoccurs with the vital signs scanner. The data samples in the one or moreshort screening windows of time may be shared or overlap with the validvital signs data capture if good signal data is being captured.

The vital signs scanning control system 1200 is executed by the vitalsigns scanner 102 in communication with the portable wireless device 104(e.g., a smartphone). The vital signs scanning control system 1200 maybe implemented in software, firmware, hardware, or a combinationthereof. As mentioned herein, the vital signs scanning user interface140 executed by the portable digital device 104 may be used to providevisual user feedback through the touchscreen display device 202 andaudible user feedback through its speaker 216. Alternatively oradditionally, the audio sound generator 847 of the vital signs scanner102 may also be used to provide audible user feedback.

The vital signs scanning control system 1200 includes a sensor datafusion process 1201, and a scan state machine 1220 coupled incommunication together. Data samples from the ECG sensor, the pulseoximeter sensor, and the accelerometer are received by the vital signsscanning control system 1200. Data samples from the ECG sensor are usedin an ECG data evaluation process 1203E in the sensor data fusionprocess 1201. Data samples from the pulse-oximeter are used in a PulseOxdata evaluation process 1203O in the sensor data fusion process 1201.Data samples from the accelerometer are used in a motion detectionprocess 1207 in the sensor data fusion process 1201. Data samples fromthe temperature sensor may optionally be used in a temperature dataevaluation process 1203T in the sensor data fusion process 1201.

The fusion process 1201 combines or fuses together the results of theECG data evaluation process 1203E and the PulseOx data evaluationprocess 1203O to determine good, poor, or invalid scan signal data foreach. The results of temperature data evaluation process 1203T may alsobe combined or fused together with that of the ECG data evaluationprocess 1203E and the PulseOx data evaluation process 1203O. As furtherdescribed herein, the results may be logically fused together todetermine good, poor, or invalid scan signal data.

The vital signs scanning control system 1200 further fuses together theresults of the motion detection process 1207 with the ECG dataevaluation process 1203E, the PulseOx data evaluation process 1203O, andoptionally the temperature data evaluation process 1203T through the useof a state machine 1220.

The vital signs scanning control system may perform a signal processingtechnique of envelope detection 1202 upon the data samples associatedwith ECG, pulse oximeter, accelerometer, and optionally temperature.Envelope detection can be used to determine signal quality withouthaving to analyze the content details of the signals. Envelope detectionhelps to remove signal variations of high frequency. While envelopedetection and other techniques and processes are described herein, otherknown signal processing techniques may be used by the one or moreembodiments of the invention to implement the data quality screeningprocess. For example, a mean value may be subtracted from a sensorsignal that may reach full range/scale or maximum amplitude values(e.g., digital 8 bit signal with 256 maximum value), for simplerprocessing. For example, a constant of 128 (256/2) may be subtractedfrom the signal value at each time step to reduce the signal range afterforming an absolute value to be between 0 and a maximum value of 128.For motion detection, a mean constant of one (1) g may be subtractedfrom values generated by the accelerometer. After subtracting the meanvalue, envelope detection may be performed.

One method of implementing envelope detection is to apply a mathematicalfunction to the input signals and then a low pass filter on theresultant mathematical signal output to form a portion of an envelopecurve so that the envelope data can be further evaluated. A HilbertTransform method of envelope detection may alternatively be used. Afterperforming envelope detection 1202, the interactive vital signs scanningcontrol system then performs various evaluations 1204-1207 on thedetected envelope curves.

Generally, the system performs a temperature evaluation 1204 upon thetemperature envelope curve. The system performs an ECG evaluation 1205on the ECG envelope curve. The system also performs a pulse oximeterevaluation 1206 on the pulse oximeter envelope curve. The system furtherperforms a motion detection 1207 upon the acceleration envelope curve.The system then makes a determination of the quality of the evaluationsmade of each envelope curve. The determination of the quality of thevital signs data may be made based upon a range of expected data, basedupon an expected curve, or based upon one or more threshold numbers.Other known methods of determining the quality of the vital signs datamay be used. Exemplary methods of how to determine the quality of thevital signs data are now described.

Referring now to FIGS. 13A-13B, the quality of a vital sign VS isdetermined using an expected range 1350. In FIG. 13A, data samples 1301Aof the vital sign VS captured by the vital signs scanner 102 are plottedagainst an axis of time T or data sample number. The data samples 1301Aundergo envelope detection to generate an envelope curve 1302A ofmeasured data. The envelope curve 1302A is compared with the expectedrange 1350. If the envelope curve 1302A over a given period of time(e.g., time windows WT1,WT2) is within the expected range 1350, then thevital sign is determined to be within range 1214G. For example, anexpected temperature range may be between 80 and 115 degrees Fahrenheit.An envelope curve for temperature measurement within this expected rangewould be deemed within temperature range 1214G.

In FIG. 13B, data samples 1301B of the vital sign VS are plotted againstthe axis of time T. The expected range 1350 remains the same. However,the envelope detection 1202 generates an envelope curve 1302B ofmeasured data. In this case, the envelope curve 1302B over a period oftime (e.g., time windows WT1,WT2) is outside the expected range 1350. Inwhich case, the quality of the vital sign VS is determined to be outsiderange 1214P. Consider for example, the same expected temperature rangebetween 80 and 115 degrees Fahrenheit. An envelope curve for temperaturemeasurement well below 80 degrees Fahrenheit, such as shown at timeperiods WT1,WT2 of FIG. 13B, would be unexpected and deemed outsidetemperature range 1214P.

When screening data samples of the vital signs scanner, it is desirableto quickly determine the quality. Thus, the sample size is somewhatsmall and does not lend itself to be properly aligned in time with anexpected curve. An expected range may be used to determine quality ofthe vital sign data samples.

Referring now to FIGS. 14A-14B, the quality of a vital sign VS isdetermined using envelope detection and thresholds. In FIG. 14A, datasamples 1401A of the vital sign VS captured by the vital signs scanner102 over a window of time (a number of samples) are plotted against anaxis of time T to form the curve 1410. The data samples 1401A undergoenvelope detection to generate an envelope curve 1430 for the sampleddata. In this case, intermediate data and its curve 1420 can begenerated from the data samples 1401A of curve 1410 using a mathematicalfunction. An exemplary mathematical function for intermediate data (ID)is ID=√{square root over ((RD−EA)²)} where the difference between rawdata samples (RD) 1401A and an expected average value (EA) 1412 issquared and then a square root is taken to determine an intermediatedata value (ID) 1402A for the intermediate curve 1420. Squaring shiftshalf the energy of the signal to higher frequency and half towards zerofrequency or direct current DC signal. A low pass filter may then beused to filter out high frequency energy to determine the envelope curve1430. Down sampling may also be employed to assist in the generation ofthe envelope curve 1430 and its amplitude values of its data samples1403A.

Referring now to FIG. 14B, after envelope detection, threshold levels1460-1461 may be used to distinguish between good, poor and invalidsignal quality in the vital signs sensor data. A poor threshold level1461 and an invalid threshold level 1460 may be established todistinguish between good, poor and invalid signal quality. The levelsmay be established based on the expected range around an expectedaverage.

In one embodiment, if the actual measurements are fully or substantiallysaturated, the signal quality is deemed invalid. Assuming an 8 bitamplitude signal, a maximum value is 256. Further assume that theexpected average is 128. An invalid signal with full saturation would bethe outside range of positive 128 and negative 128 around the expectedaverage of 128.

Assume that a range within positive 50 and negative 50 around theexpected average of 128 to be good signal quality. Translating thisexample to the envelope curve, amplitude values between zero and 49 maybe good signals, amplitude values between 50 and 127 may be poorsignals, and amplitude values from 128 and above may be invalid signals.Accordingly, the poor threshold level 1461 would be set to 50 and theinvalid threshold level set to 128, for example.

The data samples 1403A during time window WT1 are substantially at theinvalid threshold level 1460, in some cases exceeding it. If the circuitgenerating these sample values was expected to generate signal levelswell below a saturation level, then the quality of the signals beinggenerated substantially at or above the saturation level may be deemedas having an invalid signal or data quality.

The data samples 1403C during time window WT3 are below the invalidthreshold level 1460 and meet or exceed the poor threshold level 1461.Accordingly, the data samples 1403C during time window WT3 may be deemedhaving a poor signal or data quality.

The data samples 1403B during time window WT2 are below the poorthreshold level 1461. A signal with data samples below the lowerthreshold level 1461 may be deemed to have a good signal or dataquality.

In this manner, quality of initial scan data from vital sign sensorsduring an interactive screening process can be quantified into invalid,poor, or good signal data.

Regarding the Pulse oximeter sensor, the RED and IR output signals forits RED LED and IR LED are expected to be good signals because thecontroller is designed to control the current used by the RED and IRLEDs. In accordance with one aspect of the invention, the RED and IRoutput signals have a good dynamic range and avoid full signalsaturation during normal measurements. Thus, the evaluation of invalidsignal quality for pulse oximetry may be based on whether or not theactual signal measurements are fully saturated. If not fully orsubstantially saturated, the signal quality of the pulse oximeter sensordata is not invalid. If fully or substantially saturated, then thesignal quality of the pulse oximeter sensor data may be deemed invalid.For poor signal quality of the pulse oximeter sensor data, the datasamples may meet or exceed a lower poor threshold level but not the fullsaturation level. For good signal quality of pulse oximeter sensor data,the data samples may not meet or exceed both the lower poor thresholdlevel and the full saturation level.

Similar to the Pulse oximeter, in accordance with one aspect of theinvention, the ECG circuitry in the scanner is designed to outputsignals that have good dynamic range and avoid full saturation.Accordingly, the evaluation of invalid ECG data can be based on whetheror not the actual measurements are fully saturated or substantiallysaturated. If not fully or substantially saturated, the signal qualityof the ECG sensor data is not invalid. If fully or substantiallysaturated, then the signal quality of the ECG sensor data may be deemedinvalid. For poor signal quality of the ECG sensor data, the datasamples may meet or exceed a lower poor threshold level but not the fullsaturation level. For good signal quality of ECG sensor data, the datasamples may not meet or exceed both the lower poor threshold level andthe full saturation level.

Referring back to FIG. 12, other known methods may be used to quicklydetermine a quality of scan data (e.g., good, poor, or invalid scansignal data) that is being captured by each sensor. Regardless, theresults of the evaluation processes 1203E and 1203O, and optionally theresults of the temperature evaluation process 1203T, may be logicallyfused together to determine an overall quality of good, poor, or invalidscan signal data being captured by the vital signs scanner.

To determine overall that good signal data is being captured, a logicalAND operation is performed ANDing together the conditions of goodPulseOX 1216G and good ECG 1215G. Optionally, the condition oftemperature within range 1214G may also be ANDed together with goodPulseOX 1216G and good ECG 1215G to determine that good scan signal datais being obtained. For example, if all of temperature within range1214G, good PulseOX 1216G, and good ECG 1215G are generated, then theoverall scanned signal result is good. This overall result can then befused together with the detected motion condition through the statemachine 1220 to further refine the state and quality of scan signal databeing captured by the vital signs scanner.

To determine overall that poor signal data is being captured, a logicalOR operation is performed ORing together the conditions of poor PulseOX1216P and poor ECG 1215P. Optionally, the condition of temperaturewithin range 1214G may also be ANDed with the logic OR of the poorPulseOX 1216P and the poor ECG 1215P to determine that poor scan signaldata is being obtained. Even though good temperature data may be scannedwithin temperature range 1214G, poor PulseOX 1216P or poor ECG 1215P dueto the scanner being pressed too hard or too light, the overall scannedsignal data result is poor. This overall result can then be fusedtogether with the detected motion condition through the state machine1220 to further refine the state and quality of scan signal data beingcaptured by the vital signs scanner.

To determine overall that invalid signal data is being captured, alogical OR operation is performed ORing together the conditions ofinvalid PulseOX 1216I and invalid ECG 1215I. For example, if eitherinvalid PulseOX 1216I or invalid ECG 1215I are generated or true, theoverall scanned signal result is invalid. Optionally, the condition oftemperature outside range 1214P may also be logically ORed together withinvalid PulseOX 1216I and invalid ECG 1215I, to determine that invalidscan signal data is being obtained. In this case, if temperature outsiderange 1214P, invalid PulseOX 1216I, or invalid ECG 1215I are generatedor true, the overall scanned signal result is invalid. The overall scansignal result can then be fused together with the detected motioncondition through the state machine 1220 to further refine the state andquality of scan signal data being captured by the vital signs scanner.

After evaluation of the acceleration envelope curve by the motiondetection process 1207, a condition 1217B,1217M, or 1217S of thedetected motion can be assigned during the interactive scanning process.The detected motion conditions of the current scanning process includesignificant motion (big motion) 1217B, minor motion (small motion)1217M, or no motion (still) 1217S.

The detected motion condition may be assigned based upon an analysis ofthe envelope curves for the overall acceleration of the scanner incomparison with normal gravity. If there is a significant change ordifference in overall acceleration of the scanner in comparison withgravity in a window of time, then significant or big motion 1217B may beassigned. If there is a minor variation in overall acceleration of thescanner in comparison with gravity over a window of time, then thecondition of minor motion 1217M may be assigned. If there is littledifference in overall acceleration of the scanner in comparison withgravity over a window of time, e.g., a steady state, then still or nomotion 1217S may be assigned.

The concurrent detected motion condition and the evaluation of eachvital signs measurement for the given scanning session are combinedtogether by a scan state machine 1220 to be a collaborative decision onthe quality of the given scanning session. In response to the detectedmotion condition and the initial quality screening of vital signs data,the current interactive scanning process may be assigned a state withinthe scan state machine 1220. Evaluation of the audio sounds captured bythe microphone of the scanner or portable device may also be consideredin assigning a state for the scan state machine 1220.

If the detected motion condition is significant or big motion 1217B,none of the vital sign measurements are deemed accurate. The scan statemachine 1220 may be assigned a scan state of significant motion 1221,regardless of the results of the sensor data quality screening.

If the detected motion condition is small or minor motion 1217M or nomotion (still) 1217S, the vital sign data quality plays a role indetermining the fused scan state of the scan state machine 1220. Methodsof determining how the data quality states of good ECG data 1215G, poorECG data 1215P, and invalid data ECG 1215I were previously described.Methods of determining how the data quality states of good PulseOX data1216G, poor PulseOX data 1216P, and invalid PulseOX data 1216I werepreviously described. Methods of determining how the data quality statesof within temperature range 1214G and outside temperature range 1214Pwere previously described.

If the detected motion condition is minor motion 1217M, the quality ofthe vital signs data can cause the scan state machine 1220 to have thestates good signal with motion 1224A, poor signal with motion 1224B, orinvalid signal with motion 1224C depending upon the screened quality ofthe vital sign data. If either the pulse oximeter data has a dataquality state of invalid PulseOX data 1216I or the ECG data has a dataquality state of invalid ECG data 1215I, then the scan state machine1220 of the interactive scanning process may be assigned the scan stateof invalid signal with motion 1224C. If the pulse oximeter data has adata quality state of poor PulseOX data 1216P, the ECG data has a dataquality state of poor ECG data 1215P, or the temperature data has a dataquality state of outside temperature range 1214P, then the scan statemachine 1220 of the interactive scanning process may be assigned thescan state of poor signal with motion 1224B. If the pulse oximeter datahas a data quality state of good PulseOX data 1216G, the ECG data has adata quality state of good ECG data 1215G, and the temperature data hasa data quality state of within temperature range 1214G, then the scanstate machine 1220 of the interactive scanning process may be assignedthe scan state of good signal with motion 1224A.

If the detected motion condition is still or no motion 1217S, thequality of the vital signs data can cause the scan state machine 1220 tohave the scan states of good signal 1226A, poor signal 1226B, or invalidsignal 1226C. If either the pulse oximeter (PulseOX) data has a dataquality state of invalid PulseOX data 1216I or the ECG data has a dataquality state of invalid ECG data 1215I, then the scan state machine1220 of the interactive scanning process may be assigned the scan stateof invalid signal 1226C. If the pulse oximeter data has a data qualitystate of poor PulseOX data 1216P, the ECG data has a data quality stateof poor ECG data 1215P, or the temperature data has a data quality stateof outside temperature range 1214P, then the scan state machine 1220 ofthe interactive scanning process may be assigned the scan state of poorsignal 1226B. If the pulse oximeter data has a data quality state ofgood PulseOX data 1216G, the ECG data has a data quality state of goodECG data 1215G, and the temperature data has a data quality state ofwithin temperature range 1214G, then the scan state machine 1220 of theinteractive scanning process may be assigned the scan state of goodsignal 1226A.

If the scan state machine 1220 reaches the scan state of good signal1226A, the interactive scanning process continues with the data beingevaluated and measures a plurality of vital signs data that is saved anddelivered to the digital device 104 from the scanner 102. If any otherstate is assigned, user feedback may be generated to instruct the useron how to reach the good signal state 1226A.

Referring now to FIGS. 15A-15B, state diagrams for the scan statemachine 1220 are illustrated to further explain the interactive scanningprocess provided by the portable vital signs scanner 102 and the vitalsigns scanning user interface 140. FIG. 15A illustrates the interactivescanning process, user feedback, and determinations made to maintain thesame state. Previously the logic used to enter the states of the scanstate machine 1220 was described in response to the quality of vitalsigns data and the motion detected of the scanner 102. If the quality ofscan data changes or the motion condition changes, the state machinetransitions from one scan state to another. FIG. 15B illustrates theinteractive scanning process and the user feedback that may be generatedduring transitions between scan states.

An element of time (e.g., number of time windows, or a number of datasamples) may be used by the state machines to determine if the scanstate remains the same or transition to another states as the screeningprocess continues. Furthermore, different user feedback may be generatedin response to the scan state to interactively instruct the user on howto more properly use the scanner 102 and obtain better data quality. Thescan state machine keeps track of the current scan state and the numberof time windows over which the state machine has been in the currentscan state. Time limits may be used in order to determine when tore-evaluate the current scan state (e.g., see determination blocks1502,1506-1510 in FIG. 15A) and if a transition to another scan stateshould be made. If a transition to another scan state is made, the timewindow count of the current scan state is reinitialized (e.g., seeinitialization blocks 1590A-1590F in FIG. 15A), such as to zero. Thestate machine may further keep track of history of past scan states tomake various decisions regarding the user feedback to be generated.

The scanning process is initiated by the user by pressing the scanbutton in the user interface 140 on the device 104. The scanner 102 ismoved by the user towards his/her forehead/temple for the primary scanor his/her chest for the secondary scan. The accelerometer sensor sensesthe substantial motion made to position the scanner 102 against theuser's body establishing a big motion condition 1217B. As the scanner102 is pressed against the user's body, the motion detected by theaccelerometer and the interactive scanning process over a time windowmay be reduced to the small motion condition 1217M or the no motioncondition 1217S. With an initial motion condition of the big motioncondition 1217B, the state of the scan state machine 1220 has a bigmotion scan state 1221 as its initial state.

Assume the state of the scan state machine 1220 is the big motion scanstate 1221. After a first time limit A has been exceeded while in thebig motion scan state 1221, a determination is made at process 1502 ifthe scan state continues to be the big motion scan state 1221. If yes,user feedback 1523 is generated asking the user if he/she is playingwith the scanner. The counter is incremented to keep a current count ofthe number of time windows the state machine remains in the big motionscan state 1221. If the scan state is no longer in the big motion scanstate 1221, the counter is cleared or reinitialized by theinitialization block 1590A. The scan state may no longer be in the bigmotion scan state 1221 if the accelerometer sensor no longer senses bigmotion. The scan state machine goes to a different scan state inresponse to the fused scan data quality and the motion condition.

The invalid signal with motion state 1224C and the invalid signal state1226C form an invalid super state 1540. Assume the scan state is in theinvalid super state 1540 of either the invalid signal with motion state1224C or the invalid signal state 1226C. Next at process 1506, after asecond time limit B has been exceeded while in the super state 1540, adetermination is made if the fused scan data quality and motioncondition continues to form the invalid super state 1540. If yes, userfeedback 1524C is generated asking the user to please make contact withthe scanner. The counter is incremented to keep a current count of thenumber of time windows the state machine remains in the invalid superstate 1540. If the scan state is no longer in the invalid super state1540, the counter is cleared or reinitialized by the initializationblock 1590B. The scan state may no longer be in the invalid super state1540 if a better scan data quality is determined by the screeningprocess. For example, the scan state machine may go to a poor signalwith motion state 1224B or a poor signal state 1226B. Alternatively,with still better scan data quality, the scan state machine may go to agood signal with motion state 1224A or a good signal state 1226A.

Assume the scan state machine is in the poor signal with motion state1224B. At process 1507, after a third time limit C has been exceededwhile in the poor signal with motion state 1224B, a determination ismade if the fused scan data quality and motion condition continues toform the poor signal with motion state 1224B. If yes, user feedback1524B is generated asking the user if he is pressing too gently in orderto prompt him to press harder to make better contact. The counter isincremented to keep a current count of the number of time windows thestate machine remains in the poor signal with motion state 1224B. If thescan state is no longer in the poor signal with motion state 1224B, thecounter is cleared or reinitialized by the initialization block 1590C.The scan state may no longer be in the poor signal with motion state1224B if either the accelerometer sensor no longer senses small motionand the scan state machine goes to the poor signal state 1226B inresponse to the change in the motion condition or to a different scansignal state in response to a better scan data quality or worse can dataquality. For example, the scan state machine may go to a poor signalstate 1226B if motion condition goes to a still or no motion condition1217S. With better scan data quality, the scan state machine may go to agood signal with motion state 1224A or a good signal state 1226A if themotion condition also changes to the no motion condition 1217S. Withpoorer scan data quality, the scan state machine may go to the invalidsignal with motion state 1224C or the invalid signal state 1226C if themotion condition also changes to the no motion condition 1217S.

Assume the scan state machine is in the poor signal state 1226B. Atprocess 1508, after a fourth time limit D has been exceeded while in thepoor signal state 1226B, a determination is made if the fused scan dataquality and motion condition continues to form the poor signal state1226B. If yes, user feedback 1524D is generated asking the user if he ispressing too tight in order to prompt him to press less hard to make abetter contact. The counter is incremented to keep a current count ofthe number of time windows the state machine remains in the poor signalstate 1226B. If the scan state is no longer in the poor signal state1226B, the counter is cleared or reinitialized by the initializationblock 1590D. The scan state may no longer be in the poor signal state1226B, if the accelerometer sensor no longer senses absence of motionand either the scan state machine goes to the poor signal with motionstate 1224B in response to the change in the motion condition, or thescan state machine goes to a different scan signal state in response toa better or worse can data quality. For example, the scan state machinemay go to a poor signal with motion state 1224B if motion condition goesto a small or minor motion condition 1217M. With better scan dataquality, the scan state machine may go to a good signal state 1226A or agood signal with motion state 1224A if the motion condition also changesto the minor motion condition 1217M. With poorer scan data quality, thescan state machine may go to the invalid signal state 1226C or theinvalid signal with motion state 1224C if the motion condition alsochanges to the minor motion condition 1217M.

Assume the scan state machine is in the good signal with motion state1224A. At process 1509, after a fifth time limit E has been exceededwhile in the good signal with motion state 1224B, a determination ismade if the fused scan data quality and motion condition continues toform the good signal with motion state 1224A. If yes, user feedback1524A is generated asking the user to hold still for a good scan. Thecounter is incremented to keep a current count of the number of timewindows the state machine remains in the good signal with motion state1224A. If the scan state is no longer in the good signal with motionstate 1224A, the counter is cleared or reinitialized by theinitialization block 1590E. The scan state may no longer be in the goodsignal with motion state 1224A if either the accelerometer sensor nolonger senses small motion and the scan state machine goes to the goodsignal state 1226A in response to the change in the motion condition orto a different scan signal state in response to worse scan data quality.For example, the scan state machine may go to a good signal state 1226Aif the motion condition goes to a still or no motion condition 1217S.With poorer scan data quality, the scan state machine may go to the poorsignal with motion state 1224B or the poor signal state 1226B, or theinvalid super state 1540.

Assume the scan state machine is in the good signal state 1226A. Atprocess 1510, a determination is made if the fused scan data quality andmotion condition continues to form the good signal state 1226A. If yes,user feedback may be generated in the form of a scan progress bar 1599or otherwise inform the user that good scan data quality is beingachieved. The counter is incremented to keep a current count of thenumber of time windows the state machine remains in the good signalstate 1226A. If the scan state is no longer in the good signal state1226A, the counter is cleared or reinitialized by the initializationblock 1590F. The scan state may no longer be in the good signal state1226A if the accelerometer sensor no longer senses absence of motion andthe scan state machine goes to the good signal with motion state 1224Ain response to the change in the motion condition. The scan state may nolonger be in the good signal state 1226A in response to a poorer candata quality. For example, the scan state machine may go to the poorsignal state 1226B, the poor signal with motion state 1224B, or theinvalid signal supper state 1540.

Referring now to FIG. 15B, user feedback (positive user feedback ornegative user feedback) may be generated and presented to a user as thescan data quality causes a transition between scan signal states or themotion condition changes to cause a transition between scan signalstates. As mentioned previously, audible user feedback may be generatedby a speaker or audible generator in the scanner 102 or the device 104.Visual user feedback may be generated by the user interface 140 on thedisplay of the device 104.

Scan signal states 1224A-1224C associated with the minor motioncondition 1217M may be collectively referred to as a minor motion superstate 1570A. Scan signal states 1226A-1226C associated with the stillmotion condition 1217S may be collectively referred to as a no motionsuper state 1570B.

User feedback may be generated and presented to a user as a change inthe motion condition causes a transition between scan states. Theoccurrence of big motion 1217B can result in a jump to the big motionscan state 1221 from either the minor motion super state 1570A or the nomotion super state 1570B. User feedback 1516A may be generated askingthe user audibly and/or visually if he/she is shaking the scanner 102.

If the scan state is one of the no motion super states 1570B and ifmotion is detected by the accelerometer over a time window such that theinteractive scanning process reverts back to one of the scan states inthe minor motion super states 1570A, user feedback 1516B may begenerated. The user feedback 1516B may be presented to the user audiblyand/or visually asking him/her to please hold still.

If in the good signal with motion scan state 1224A, the motion detectedby the accelerometer and the interactive scanning process over a timewindow is substantially reduced to still or no motion, the scan statemay transition to the good scan state 1226A. In this case, user feedback1516C may be generated during the transition providing positive userfeedback, such as great job, and presented to the user audibly orvisually on the display device 202 of the device 104.

In FIG. 15B, user feedback may be generated and presented to a user asthe scan data quality causes a transition between scan signal states.For example, a transition from either the invalid signal with motionstate 1224C or the invalid signal state 1226C to a better level of scandata quality and scan state, positive user feedback 1525B may begenerated and inform the user that he/she is making better contact toreinforce the improvement. On the other hand, a transition from eitherthe good signal with motion state 1224A or the good signal state 1226Ato a poorer level of scan data quality and scan state, negative userfeedback 1525A may be generated and inform the user that he/she islosing good contact with the scanner 102 to alter the behavior of theuser.

Referring now back momentarily to FIG. 15A, if the vital signs controlsystem goes to the good signal state 1226A, then the scanning processcan continue and start making measurement calculations for the vitalsigns. Some of the data in the screening process if of good quality maybe used to perform the calculation. If not, added time is used to obtainthe needed data to perform the calculations. In the good signal state1226A, user feedback 1599 is generated by displaying a scan progress barto user, for example. While in the good signal state 1226A, the scanstate is continuously revaluated by the state machine 1220. For exampleif small motion 1217M or big motion 1217B are detected, measurementcalculations may be paused due to a transition away from the good signalstate 1226A. The scan states may revert to states other than the goodsignal state 1226A. In which case, the scan progress bar 1599 isinterrupted and additional user feedback may be provided on how tocontinue or restart the scanning process. For example, the scan progressbar 1599 may be reset if the scanning process is restarted from thebeginning.

Referring now back momentarily to FIG. 15A, before measurementcalculations are presented to the user, the scan quality may optionallybe confirmed at block 1560 of the interactive scanning process. If thescan quality cannot be confirmed, the scan progress bar may beinterrupted and additional user feedback may be provided on how tocontinue or restart the scanning process. For example, the scan progressbar 1599 may be reset if the scanning process is restarted from thebeginning.

Scan quality can be confirmed by performing additional measurementcalculations. Alternatively or additionally, scan quality can beconfirmed by using multiple time windows. The multiple time windows maybe fused together to confirm that the scan data is really good bymeasuring the scan data against expected curve. An element of time isaligned between the scan data curve and an expected curve. Timealignment between curves is possible for both ECG and PPG curves becausethe shape and peaks of the curves are distinct and can be detected, forexample, by match filtering.

Referring now to FIGS. 17A-17C, the quality of a vital sign VSmeasurement calculations that were made can be confirmed using anexpected curve 1750. In FIG. 17A, data samples 1701A of the vital signVS captured by the vital signs scanner 102 are plotted against an axisof time T. The data samples 1701A undergo envelope detection to generatean envelope curve 1702A of measured data. The envelope curve 1702A iscompared with the expected curve 1750. If the pattern of the envelopecurve 1702A over a given period of time matches the pattern of theexpected curve 1750, then the good quality of the vital sign isconfirmed.

In FIG. 17B, data samples 1701B of the vital sign VS captured by thevital signs scanner 102 are plotted against an axis of time T. The datasamples 1701B undergo envelope detection to generate an envelope curve1702B of measured data. The envelope curve 1702B of the vital sign iscompared with the expected curve 1750. If the pattern of the envelopecurve 1702B over a given period of time does not match the pattern ofthe expected curve 1750, then the good quality of the vital sign is notconfirmed.

In FIG. 17C, data samples 1701C of the vital sign VS captured by thevital signs scanner 102 are plotted against an axis of time T. The datasamples 1701C undergo envelope detection in an attempt to generate anenvelope curve 1702C of measured data. The envelope curve 1702C of thevital sign is compared with the expected curve 1750. If the pattern ofthe envelope curve 1702C over a given period of time has no bearingwhatsoever to the expected curve 1750, then again the good quality ofthe vital sign is not confirmed.

The quality of the sensor data for the ECG sensor and the quality of thesensor data for the pulse oximeter sensor may both be determined bycomparing against expected curves.

If the pattern of the envelope curve of the sensor data for the ECGsensor over a given period of time matches the pattern of an expectedECG curve, then the quality of the ECG data for the ECG vital sign isconfirmed to be good. If the pattern of the envelope curve of the sensordata for the ECG sensor over a given period of time does not match thepattern of the expected ECG curve, then the good quality of the of theECG data is not confirmed. If the pattern of the envelope curve of thesensor data for the ECG sensor over a given period of time has nobearing whatsoever to the expected ECG curve, then a good quality of theof the ECG data for the vital sign is not confirmed.

If the pattern of the envelope curve of the sensor data for the pulseoximeter sensor over a given period of time matches the pattern of anexpected pulse oximeter curve, then the quality of the pulse oximeterdata for a vital sign is confirmed to be good. If the pattern of theenvelope curve of the sensor data for the pulse oximeter sensor over agiven period of time does not match the pattern of the expected pulseoximeter curve, then a good quality of the of the pulse oximeter datafor the vital signs is not confirmed. If the pattern of the envelopecurve of the sensor data for the pulse oximeter sensor over a givenperiod of time has no bearing whatsoever to the expected pulse oximetercurve, then a good quality of the of the pulse oximeter sensor data forthe vital signs is not confirmed.

If the measurement calculations are optionally confirmed at block 1560during the interactive scanning process, the measurement calculationsmay be presented to the user.

Sensor Data Fusion for Improved Vital Signs Measurements

While user feedback may be used during an interactive scanning processto improve scan quality, the plurality of different types of vital signsdata may also be used to improve the data quality by combining or fusingdata together.

Referring now to FIG. 16, a flow chart of methods including sensor datafusion to improve vital sign measurements is illustrated. The vitalsigns scanner 120 integrates a plurality of vital sign sensors 812, 880,885, 860, 875 into a low cost finger held device. The plurality of vitalsigns sensors concurrently sense data over one or more periods of timegenerating sensor data 1650 associated with vital signs of a human body.The sensor data 1650 includes sensed data 1602, 1603A-1603D,1604A-1604C, 1605A-1605C, 1606A-1606B from each of the respective vitalsigns sensors 812,880,885,860,875.

The sensed data 1602, 1603A-1603D, 1604A-1604C, 1605A-1605C, 1606A-1606Bfrom each of the respective vital signs sensors 812, 880, 885, 860, 875is used to concurrently determine a plurality of vital signs values fora respective plurality of vital signs for a given time and date.Internal logic within the vital signs scanner 120 generates values forvital signs such as surface temperature 1612, pulse blood volume 1613,and pulse rate 1614, for example.

As the vital sign data is concurrently determined from each sensor, theyare related by time and date. There may be a further relatedness betweentwo or more sensed data types or two or more vital sign values. Thisrelatedness may be exploited by fusing together two or more types ofsensed data or two or more vital sign values together to improveaccuracy/quality or to form a new, different, or related vital sign.

For example, PPG sensor data 1603C, accelerometer data of the chestarea, and ECG sensor data 1605 may be fused together to determine pulsewave transit time (PWTT) 1616 that is directly related to bloodpressure. PWTT can also be calculated non-invasively from ECG sensordata and SpO2 sensor data. The technology employed for blood pressuremeasurement may be based on the PWTT technology described in U.S. Pat.No. 5,564,427 filed by Aso et al. incorporated herein by reference. ThePWTT technology described in U.S. Pat. No. 5,564,427 may be modified toimprove PWTT measurements. 42

The precision of a PWTT measurement may be enhanced by particularmethods of cross-correlation. Additionally, epidemio biometrics (userbiometrics) 1617 may also be fused together with the PWTT data 1616(derived from accelerometer data, ECG data, and PPG sensor data) by ablood pressure algorithm 1627. For example, one or more of a user'sbiometrics of age, height, and weight (user biometrics) may be fusedtogether with the PWTT data 1616 to determine blood pressure. Largescale curated datasets or databases of hypertension may be fused alongwith the blood pressure. Likewise temperature may be used as anadditional input in order to enhance the accuracy of both systolic anddiastolic blood pressure measurements.

Two or more vital sign values of different vital signs may be fusedtogether by mathematical algorithms to improve the accuracy or qualityof the values of the one or more vital signs. Alternatively, two or morevital sign values may be fused together by mathematical algorithms toform a value for a new and different vital sign for which data is notsensed. For example, surface body temperature 1612 sensed by theinfrared thermometer sensor 812 may be fused together with pulse bloodvolume 1613 sensed by the PPG sensor 880.

Knowing the volume of blood at a core temperature that enters themicrocirculation under a probed region, and knowing the external surfacebody temperature, the value of core temperature Tcore can be obtained.Internal core temperature can be computed if the ambient temperature andthe Skin surface temperature are known both of which we get from theMelexis sensor. Heat flux q passes from the core temp (T_(c)) throughthe skin to the ambient environment (T_(a)) where the skin surface temp(T_(s)) is held at some intermediary temp between core and ambient temp.An equation for core temperature is T_(c)=(h/pc) (T_(s)−T_(a))+T_(s)where h/pc is a weighting coefficient that weights the difference inskin surface and ambient temperature and is determined empirically on astatistical basis over different patients and different clinicalsituations.

In this manner, the surface body temperature and the pulse blood volumemay be fused together by the temperature algorithm 1622 to determinecore body temperature as well as improve the surface temperature 1632.U.S. Pat. No. 7,787,938 issued to Franceso Pompei on Aug. 31, 2010describes further details of determining temperature in this manner andis incorporated by reference.

Acceleration data (motion) 1604A from the accelerometer 885 and acousticsensor data 1606A from the stereo microphone 875 may also be fusedtogether by mathematical algorithms, with or without the vital signvalues from the vital sign sensors, to improve the accuracy or qualityof vital sign values or form a value for a different vital sign. Forexample, a fusion formula 1626 may be used to fuse acoustic sensor data1606A and an axis of acceleration data to determine respiration rate1636. A 3D splitter 1615 splits up three axes of data from a tri-axisaccelerometer 885.

The formula 1623 that may be used to convert PPG sensor data 1603A-1603Dinto SPO2 data 1633 is described for example in “Pulse Oximetry: Theoryand Applications for Noninvasive Monitoring” by Yitzhak Mendelson,CLIN.CHEM. 38/9, 1601-1607 (1992); and Noninvasive Pulse OximetryUtilizing Skin Reflectance Photoplethysmogmphy” by Yitzhak Mendelson andBurt D. Ochs, IEEE Trans. On Biomedical Engineering, Vol. 35, No. 10,October 1988, pages 798-805.

A comparator formula 1624 can fuse pulse rate 1614, accelerometer data1604, and ECG sensor data 1605 together to obtain heart rate information1634. Electrocardiogram (ECG) data 1605 can be further evaluated withformulas 1625 to obtain the PR interval, the QRS shape, the ST interval,and more ECG information 1635 that is used to determine heart activity.This ECG information can be further processed by algorithms 1639 todetermine heart rate variability (HRV), the variation in the timeinterval between heartbeats, or other conditions of a users heart, aswell as stress 1649.

One or more algorithms 1628 may be used to extract sound signals fromwell defined frequency bands relative to wheezing and murmurs. Wheezingsand murmurs have very different pitches and can be easily separated on afrequency basis, even without their full spectral envelopes. Theextracted sounds of wheezings and murmurs may be used diagnose chronicobstructive pulmonary disease (COPD) or asthma 1638.

The vital signs user interface (VSUI) 140 can be used to store andpresent much of the vital signs data to a user including coretemperature 1642, SPO2 data 1643, heart rate 1644, ECG data 1645,respiration rate 1646, blood pressure 1647, and stress levels 1649.

Additional information may be requested by the user by using the vitalsigns user interface (VSUI) through information requests 1643, 1652, and1657A-1657B to better diagnose a condition.

CONCLUSION

Various specific materials, designs, dimensions, etc. are provided andare considered highly beneficial embodiments of the present disclosurein one regard. However, in other regard, such specifics are also merelyillustrative of broader aspects of the present disclosure and should notbe considered to necessarily limit to such broader aspects unlessexpressly specified to be required. In particular, the various specificdimensions provided as such examples are intended to be about anyparticular values provided, with typical tolerances and ranges ofsuitable alternatives as would be apparent to one of ordinary skill.Where particular combinations of such dimensions are provided forexemplary illustration of certain embodiments, the relativerelationships between them are also contemplated as having been hereindisclosed as additional beneficial aspects (even if the specific valuesof the relative dimensions change). For example, certain lengths,widths, and/or depths of particular components shown and described for aparticular assembly provide overall geometries which may be varied bychanging certain sub-sets of such dimensions, but may also be fixedrelative to the ratios of these values despite the valued changing (solong as their general relationship remains). Similarly, such dimensionsof different component parts also have similar relative relationshipswhich are similarly contemplated, also as apparent to one of ordinaryskill.

When implemented in software, the elements of the embodiments of theinvention are essentially the code segments or instructions to performthe functional tasks described herein. The code segments or instructionsare executable by a processor, such as processor 206, 840, and can bestored in a storage device or a processor readable storage medium, suchas memory 208, 841, awaiting execution. The processor readable storagemedium may include any medium that can store information. Examples ofthe processor readable storage medium include an electronic circuit, asemiconductor memory device, a read only memory (ROM), a flash memory,an erasable programmable read only memory (EPROM), a floppy diskette, aCD-ROM, an optical disk, a hard disk. The code segments or instructionsmay be downloaded via computer networks such as the Internet, Intranet,etc. into the processor readable storage medium.

Various combinations and sub-combinations, and modifications as may bemade, of the presently disclosed components and embodiments and aspectsare contemplated whether or not specifically disclosed hereunder, to theextent and as would be apparent to one of ordinary skill based uponreview of this disclosure and in order to suit a particular intendedpurpose or application.

While certain embodiments of the disclosure have been described, theseembodiments have been presented by way of example only, and are notintended to limit the scope of the disclosure. Indeed, the novelmethods, systems, and devices described herein may be embodied in avariety of other forms. Furthermore, various omissions, substitutionsand changes in the form of the methods, systems, and devices describedherein may be made without departing from the spirit of the disclosure.For example, certain features that are described in this specificationin the context of separate implementations may also be implemented incombination in a single implementation. Conversely, various featuresthat are described in the context of a single implementation may also beimplemented in multiple implementations, separately or insub-combination. Moreover, although features may be described above asacting in certain combinations and even initially claimed as such, oneor more features from a claimed combination may in some cases be excisedfrom the combination, and the claimed combination may be directed to asub-combination or variations of a sub-combination. Accordingly, theclaimed invention is to be limited only by patented claims that followbelow.

What is claimed is:
 1. A method comprising: with a portable vital signsscanner having a plurality of different vital signs sensors, receivingfirst motion data corresponding to a first motion of a user; receivingsecond motion data corresponding to a second motion of the user, thesecond motion data indicating that the second motion is smaller than thefirst motion; determining that a difference between the first motiondata and the second motion data is greater than a predeterminedthreshold; concurrently sensing data from a user with the plurality ofdifferent vital signs sensors over a period of time; over the period oftime, determining a plurality of different vital sign values for arespective plurality of different vital signs associated with the userin response to the sensed data from one or more of the plurality ofdifferent vital sign sensors; and based on the difference determinationbetween the first motion data and the second motion data, designating atleast two vital sign values as valid; fusing together at least twodifferent vital sign values that were designated as valid to improve thequality of at least one vital sign value of a vital sign.
 2. The methodof claim 1, further comprising: fusing a first vital sign valuedesignated as valid with a second vital sign value designated as valid,the vital signs associated with the user; generating a third vital signvalue associated with the user without the need for sensing the thirdvital sign value directly from the user; and designating the third vitalsign value as valid.
 3. The method of claim 1, further comprising:combining electrocardiogram (ECG) scan data and photoelectricplethysmogram (PPG) scan data together with user biometrics; andderiving a value for blood pressure, wherein the user biometrics are oneor more of the set of height, weight, sex, and age of a user.
 4. Themethod of claim 1, wherein scan data for at least two vital sign valuesof the plurality of vital sign values can be fused together to form avalue for respiration rate or heart rate.
 5. The method of claim 1,wherein sensed data from one vital sign sensor is used to derive aplurality of different vital sign values.
 6. The method of claim 5,wherein sensed data from a pulse oximeter (PulseOX) sensor is used toderive values for blood oxygenation (SpO2) and pulse rate.
 7. The methodof claim 5, wherein sensed data from an electrocardiogram (ECG) sensoris used to derive heart rate and heart rate variability.
 8. The methodof claim 1, further comprising: sensing acceleration of the portablevital signs scanner; determining movement of the portable vital signsscanner along a first axis in response to the sensed acceleration;sensing sounds around the portable vital signs scanner; and fusing themovement along the first axis with sounds around the portable vitalsigns scanner to form a value for respiration rate.
 9. The method ofclaim 1, further comprising: determining pulse rate from photoelectricplethysmogram (PPG) sensor data; sensing acceleration of the portablevital signs scanner; comparing the pulse rate with the sensedacceleration and electrocardiogram (ECG) sensor data to form a value forheart rate.
 10. The method of claim 1, further comprising: determiningpulse blood volume from photoelectric plethysmogram (PPG) sensor data;determining surface temperature from infrared temperature sensor data;and fusing the pulse blood volume with the surface temperature to form acore body temperature.
 11. The method of claim 1, further comprising:receiving epidemio biometrics information; performing a pulse wavetransit time (PWTT) on electrocardiogram (ECG) sensor data, andphotoelectric plethysmogram (PPG) sensor data; and fusing the PWTT datawith the epidemio biometrics information by using an algorithm to formhigh blood pressure or hypertension information.
 12. A methodcomprising: forming a circuit comprising a first electrode for makingcontact at a first point on a user, and a second electrode for makingcontact at a second point on the user, the first electrode configuredfor coupling to the second electrode through the first point and thesecond point; selecting a sensor from a set of vital signs sensors;determining a first resistivity comprising an electrical resistance atone or more of the first electrode and the second electrode; comparingthe first resistivity to a predetermined threshold; concurrently sensingdata from the user with the set of vital signs sensors over a period oftime; over the period of time, determining a plurality of differentvital sign values for a respective plurality of different vital signsassociated with the user in response to the sensed data from sensorsselected from the set of vital sign sensors; based on the comparison ofthe first resistivity to the predetermined threshold, designating atleast two of the determined vital sign values as valid; and fusingtogether at least two different vital sign values designated as valid toform a value of another vital sign associated with the user.
 13. Themethod of claim 12, further comprising: fusing together at least twodifferent vital sign values that were designated as valid to improve thequality of at least one vital sign value.
 14. The method of claim 12,further comprising: combining electrocardiogram (ECG) scan data andphotoelectric plethysmogram (PPG) scan data together with userbiometrics; and deriving a value for blood pressure, the user biometricsare one or more of the set of height, weight, sex, and age of a user,wherein scan data for at least two vital sign values of the plurality ofvital sign values can be fused together to form a value for respirationrate or heart rate.
 15. The method of claim 12, wherein sensed data fromone vital sign sensor is used to derive a plurality of different vitalsign values.
 16. The method of claim 15, wherein sensed data from apulse oximeter (PulseOX) sensor is used to derive values for bloodoxygenation (Sp02) and pulse rate.
 17. The method of claim 15, whereinsensed data from an electrocardiogram (ECG) sensor is used to deriveheart rate and heart rate variability.
 18. The method of claim 12,further comprising: sensing acceleration having a direction; determiningmovement along a first axis in response to the sensed acceleration;sensing sounds proximate to a sensor in the set of vital sign sensors;and fusing the movement along the first axis with selected sounds thatwere sensed in proximity to the sensor to form a value for respirationrate.
 19. The method of claim 12, further comprising: determining pulserate from photoelectric plethysmogram (PPG) sensor data; sensingacceleration of the portable vital signs scanner; comparing the pulserate with the sensed acceleration and electrocardiogram (ECG) sensordata to form a value for heart rate.
 20. The method of claim 12, furthercomprising: determining pulse blood volume from photoelectricplethysmogram (PPG) sensor data; determining surface temperature frominfrared temperature sensor data; and fusing the pulse blood volume withthe surface temperature to form a core body temperature.
 21. The methodof claim 12, further comprising: receiving epidemio biometricsinformation; performing a pulse wave transit time (PWTT) onelectrocardiogram (ECG) sensor data, and photoelectric plethysmogram(PPG) sensor data; and fusing the PWTT data with the epidemio biometricsinformation using an algorithm to form high blood pressure orhypertension information.